JAMA Netw Open
Fluticasone–vilanterol edges out other combo inhaler options in COPD
In a large retrospective cohort study with propensity-score matching, researchers compared once-daily fluticasone furoate–vilanterol (dry powder), twice-daily fluticasone propionate–salmeterol (dry powder), and twice-daily budesonide–formoterol (metered-dose). Across matched cohorts (38,070; 20,471; and 55,627 pairs), fluticasone furoate–vilanterol was associated with a 9% lower risk of moderate/severe COPD exacerbation vs. budesonide–formoterol (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.88-0.94) and a 6% lower risk vs. fluticasone propionate–salmeterol (HR, 0.94; 95% CI, 0.89-0.98).
No differences were observed in pneumonia hospitalization risk across the three cohorts (fluticasone furoate-vilanterol vs. budesonide-formoterol: HR, 1.03; 95% CI, 0.96-1.11; fluticasone furoate-vilanterol vs. fluticasone propionate-salmeterol: HR, 0.93; 95% CI 0.85-1.03).
Clinical takeaway: A once‑daily fluticasone furoate–vilanterol regimen may provide a modest edge in reducing exacerbations without increasing pneumonia risk compared with commonly used twice‑daily ICS/LABA options.
Source:
Feldman WB, et al. (2026, March 9). JAMA Netw Open. Fluticasone- vs Budesonide-Based Dual Therapy for COPD. https://pubmed.ncbi.nlm.nih.gov/41801200/