title: Revising old principles of inhaled treatment in new fixed combinations for asthma.
abstract: The major influencing factors on persistent asthma control are the selected treatment(s), the drug delivery route and patient's adherence to therapy, together with the influence of lifestyle (i.e. sedentary habit), comorbid conditions and specific asthma phenotypes. Inhaled corticosteroids (ICS) in combination with a long-acting β2-agonist (LABA) are the gold standard for management of persistent asthma, with maximal local targeting and minimal systemic side effects. Several innovative inhaler devices have been developed for effective local drug administration and good patient compliance to therapy. Recently, a new ICS/LABA fixed combination, formulated with fluticasone propionate (FP) and formoterol fumarate (FF), has been proposed for maintenance treatment of asthma in adults and adolescent patients. FP/FF combines the anti-inflammatory and bronchodilating properties of powerful compounds in a single inhaler. Its pharmacological characteristics allow rapid speed of onset and dosage flexibility required for step-up and step-down strategies, improving adherence to treatment of asthmatic patients. The efficacy of the FP/FF fixed combination at all dosages in controlling asthma symptoms and the reduced rate of discontinuation have been demonstrated by all randomized trials conducted so far.
authors.affiliation: Department of Medicine, University of Palermo, Palermo, Italy. Electronic address: nicola.scichilone@unipa.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Scichilone
authors.affiliation: Pulmonary Unit, A.O.U.I and University of Verona, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Respiratory Pathophysiology, S.Maria Scotte Hospital, AOU of Siena, Siena, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Melani
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D004338:Drug Combinations; D000068298:Fluticasone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000068759:Formoterol Fumarate / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D055118:Medication Adherence
chemical_list: D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D004338:Drug Combinations; D000068298:Fluticasone; D000068759:Formoterol Fumarate
keywords: Asthma; Corticosteroid; Fluticasone propionate; Formoterol fumarate; Inhaled treatment