Objective  To systematically evaluate the clinical efficacy and safety of fluticasone furoate in the treatment of bronchial asthma. Methods  We electronically searched databases including PubMed, The Cochrane Library (Issue 2, 2016), CNKI, VIP, and WanFang Data to collect randomized controlled trials (RCTs) about fluticasone furoate for bronchial asthma from inception to Feb. 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results  Six RCTs involving 4 383 patients were included. The results of meta-analysis showed that: (1) Fluticasone furoatevs. placebo: fluticasone furoate could not only significantly improve trough FEV₁ (MD=0.10, 95%CI 0.05 to 0.15,P=0.000 2), but also improve the percentage of rescue-free in 24 hours and the symptom-free periods in 24 hours. Meanwhile, fluticasone furoate could not increase the adverse events rate (OR=1.38, 95%CI 0.28 to 6.77,P=0.69). (2) Fluticasone furoate plus vilanterolvs. fluticasone furoate alone: Compared with fluticasone furoate alone, fluticasone furoate plus vilanterol could significantly improve FEV₁ (MD=–0.10, 95%CI –0.19 to –0.01,P=0.02) and 0–24 h wmFEV₁ (MD=–0.10, 95%CI –0.19 to –0.01,P=0.02). the combination therapy also had better percentage of rescue-free in 24 hours and symptom-free periods in 24 hours without increasing the rate of adverse events (OR=–1.05, 95%CI –1.39 to –0.80,P=0.72). (3) Fluticasone furoatevs. fluticasone propionate: There were no significant differences between fluticasone furoate and fluticasone propionate in FEV₁ (MD=–0.02, 95%CI –0.08 to 0.04,P=0.52), percentage of rescue-free in 24 hours and adverse events rate (OR=1.62, 95%CI 0.77 to 3.40,P=0.20). Conclusion  Current evidence shows, fluticasone furoate could effectively improve the lung function and control the symptoms of asthma patients than placebo; fluticasone furoate plus vilanterol shows better effects than fluticasone furoate alone without increasing the adverse event rate. Fluticasone furoate and fluticasone propionate have similar effects, but fluticasone furoate is more convenient and could improve patients’ adherence. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： ZHANG Fei, JIANG Bing, MIAO Lili. Efficacy and safety of fluticasone furoate in the treatment of bronchial asthma: a systematic review. Chinese Journal of Evidence-Based Medicine, 2017, 17(1): 33-39. doi: 10.7507/1672-2531.201605056 Copy