A once-daily treatment regimen of combined fluticasone furoate and vilanterol was associated with fewer exacerbations in patients with COPD who have a history of exacerbations.

In a controlled effectiveness trial conducted in 75 general practices, researchers randomly assigned 2,799 patients with COPD to a once-daily inhaled combination of fluticasone furoate (100 ?g) and vilanterol (25 ?g) or to usual care.

The rate of moderate or severe exacerbations—the primary outcome—was significantly lower, by 8.4% (95% confidence interval, 1.1 to 15.2), with fluticasone furoate–vilanterol therapy than with usual care (P=0.02).

Secondary outcomes included rates of primary and secondary care contact, modification of the initial trial treatment for COPD, and exacerbation rates. Among the findings:

-There was no significant difference in the annual rates of COPD-related contacts to primary or secondary care.

-There were no significant between-group differences in the rates of the first moderate or severe exacerbation and the first severe exacerbation.

-There were no excess serious adverse events of pneumonia in the fluticasone furoate–vilanterol group.

-The numbers of other serious adverse events were comparable in the two groups.

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