Abstract：
Inhaled corticosteroid and ultra-long-acting beta-agonist (ICS/uLABA) combination is a recent advancement in the armamentarium against obstructive airways diseases (OADs). The combination of ICS/uLABA has several advantages, creating a favorable landscape for its utilization. Fluticasone furoate/vilanterol trifenatate (FF/Vi) is one such example of an ICS/uLABA. It offers several benefits from both drugs, such as a convenient once daily dosing schedule; high lipophilicity; high receptor affinity of fluticasone furoate along with high functional selectivity and a quick onset of action of vilanterol. However, the Global Initiative for Asthma (GINA) as well as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines do not clearly define the positioning of ICS/uLABA compared to conventional ICS/LABAs. There are a few areas of uncertainty especially around the appropriate reliever strategy with ICS/uLABA in Asthma. The current consensus was planned with a group of Indian pulmonology experts to provide more clarity on the potential use of FF/Vi in Asthma and COPD. The clinical statements highlighted in this consensus manuscript address crucial clinical questions revolving around the efficacy and safety of FF/Vi as compared to conventional ICS/LABAs and identify the ideal patient profile for its use. This consensus paper also sheds light upon the appropriate reliever to be used along with FF/Vi in Asthma and the utilization of FF/Vi-based triple therapy in OADs. Expert recommendations mentioned in this paper will serve as guidance to pulmonologists as well as consultant physicians who are involved in providing care to OAD patients and will help them weigh the various factors that need to be taken into account while prescribing ICS/uLABA combination.
摘要：
吸入皮质类固醇和超长效β-激动剂（ICS/uLABA）组合是对抗阻塞性气道疾病（OAD）的最新进展。ICS/uLABA的组合有几个优点，为其利用创造有利的景观。糠酸氟替卡松/曲芬酯维兰特罗(FF/Vi)是ICS/uLABA的一个这样的实例。这两种药物都有几个好处，例如方便的每日一次给药方案；高亲脂性；糠酸氟替卡松的高受体亲和力以及高功能选择性和维兰特罗的快速起效。然而,与常规ICS/LABA相比,全球哮喘倡议(GINA)和全球慢性阻塞性肺疾病倡议(GOLD)指南没有明确界定ICS/uLABA的定位.有一些不确定的地方，特别是在哮喘中使用ICS/uLABA的适当缓解策略。目前的共识是计划与一组印度肺病学专家达成的，以更清楚地说明FF/Vi在哮喘和COPD中的潜在用途。与常规ICS/LABA相比，本共识手稿中强调的临床陈述解决了围绕FF/Vi的有效性和安全性的关键临床问题，并确定了理想的患者使用情况。这份共识文件还阐明了在哮喘中与FF/Vi一起使用的适当缓解剂以及在OAD中使用基于FF/Vi的三联疗法。本文中提到的专家建议将为肺科医师以及参与为OAD患者提供护理的顾问医师提供指导，并将帮助他们权衡在处方ICS/uLABA组合时需要考虑的各种因素。
