Laventair Ellipta (previously Laventair)

Laventair Ellipta can only be obtained with a prescription. It is available as an inhalation powder in a portable inhaler device. Each inhalation provides 65 micrograms of umeclidinium bromide (equivalent to 55 micrograms of umeclidinium) and 22 micrograms of vilanterol.

The recommended dose is one inhalation per day at the same time each day. For detailed information on using the inhaler correctly, see the instructions in the package leaflet or contact your doctor and pharmacist.

Laventair Ellipta contains two active substances. Vilanterol is a long-acting beta-2 agonist. It works by attaching to beta-2 receptors found in the muscle cells of many organs including the airways in the lungs. When inhaled, vilanterol reaches the receptors in the airways and activates them. This relaxes the muscles of the airways.

Umeclidinium bromide is a muscarinic receptor antagonist. It works by blocking other receptors called muscarinic receptors, which control the contraction of muscles. When umeclidinium bromide is inhaled, it relaxes the muscles of the airways.

The combined action of the two active substances helps to keep the airways open and allows the patient to breathe more easily. Muscarinic receptor antagonists and long-acting beta-2 agonists are commonly combined in the management of COPD.

Laventair Ellipta and a higher-dose combination of umeclidinium bromide and vilanterol were compared with placebo (a dummy treatment), vilanterol alone, umeclidinium bromide alone and another COPD medicine called tiotropium in 4 main studies.

In all 4 studies, involving over 4,700 patients, the main measure of effectiveness was based on changes in the patients’ forced expiratory volumes (FEV₁, the maximum volume of air a person can breathe out in one second).

Results showed that Laventair Ellipta improved lung function by an average FEV₁ of 167 ml more than placebo after 24 weeks of treatment. Laventair Ellipta also increased FEV₁ by an average of 95 ml more than vilanterol alone and by 52 ml more than umeclidinium bromide alone. The average increase in FEV₁ with Laventair Ellipta was 90 ml more than with tiotropium after 24 weeks of treatment.

Laventair Ellipta was also shown to improve symptoms such as breathlessness and wheezing.

The results for the higher dose combination of umeclidinium bromide and vilanterol did not consistently show relevant improvements in lung function to justify its use.

The most common side effects with Laventair Ellipta (which may affect up to 1 in 10 people) are upper respiratory tract infections (nose and throat infection), urinary tract infections (infection of the structures that carry urine), pharyngitis (inflammation of the throat), sinusitis (inflammation of the sinuses), nasopharyngitis (inflammation of the nose and throat), headache, cough, oropharyngeal pain (pain in the mouth and throat), constipation and dry mouth.

For the full list of side effects and restrictions, see the package leaflet.

The European Medicines Agency decided that Laventair Ellipta’s benefits are greater than its risks and recommended that it can be authorised for use in the EU. The Agency concluded that Laventair Ellipta was shown to be effective at improving lung function and the symptoms of COPD when compared with placebo or the single components as well as with tiotropium. The Agency also noted that there were no major safety concerns with Laventair Ellipta, with side effects being manageable, although the long-term safety data so far are limited. To investigate this further the Agency recommended that a study be carried out.

As medicines of the same class as Laventair Ellipta may have an effect on the heart and blood vessels in the brain, the company that markets the medicine will carry out a long-term study in patients to collect further information on its safety in comparison with tiotropium.

Recommendations and precautions to be followed by healthcare professionals and patients have also been included in the summary of product characteristics and the package leaflet.

As for all medicines, data on the use of Laventair Ellipta are continuously monitored. Side effects reported with Laventair Ellipta are carefully evaluated and any necessary action taken to protect patients.

Laventair Ellipta received a marketing authorisation valid throughout the EU on 8 May 2014.