In a Real-World Setting, Fluticasone plus Vilanterol Lowered Risk for COPD Exacerbations

Patients in chronic obstructive pulmonary disease (COPD) clinical trials often do better than real-world patients because of strict entry criteria, close follow-up, and better medication adherence. In this industry-funded “integrated comparative effectiveness trial,” researchers evaluated inhaled combination fluticasone furoate and vilanterol (Breo Ellipta) in a less rigorous, primary care–setting protocol. About 2800 patients in U.K. general practices with COPD who required daily therapy and had at least one exacerbation within the previous year were randomized to once-daily inhaled fluticasone furoate (100 μg) plus vilanterol (25 μg) or usual care. Usual care consisted of any combination of inhaled corticosteroids (ICS), long-acting β-ago…