Product menu

  • Prescribing and adverse event reporting information is at the foot of this page
image of glass coloured blocks

GOLD and NICE do not encourage ICS/LABA initiation in COPD patients1,2

NICE: for patients with no asthmatic features/features of steroid responsiveness
GOLD & NICE recommend classes of medicines, not individual products

Initial Maintenance Therapy

GOLD & NICE recommendations for COPD patients limited by symptoms

Adapted visual shows only GOLD group B and NICE guidance for patients with
no asthmatic features or features suggesting steroid responsiveness

GSK adapted visual of GOLD and NICE guidance

Before starting inhaled therapy GOLD and NICE recommend considering non-pharmacological approaches, such as smoking cessation, pulmonary rehabilitation etc. A short-acting bronchodilator is recommended by GOLD and NICE for additional immediate symptom relief, if needed.
Please refer to individual SmPCs before prescribing

LAMA/LABAs are licensed in the UK as maintenance bronchodilator treatments to relieve symptoms in adult COPD patients.
LAMA/LABAs are not licensed in the UK to treat or reduce the risk of exacerbations.

GSK-adapted from © 2025 Global Strategy for the Diagnosis, Management and Prevention of COPD. All rights reserved. Use is by express license from the owner.
GSK-adapted from © NICE 2019. COPD in over 16s: diagnosis and management. Available from www.nice.org.uk/guidance/ng115. All rights reserved. Subject Notice of rights. NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this material.

LABA/LAMA vs ICS/LABA graph

Why a LAMA/LABA?

For example, in a 12-week, double-blind trial, COPD patients received once-daily Anoro ︎Ellipta (umeclidinium/vilanterol) - LAMA/LABA (n=332), or twice-daily Seretide Accuhaler 50µg/500µg (fluticasone propionate/salmeterol) - an ICS/LABA (n=337)3

The LAMA/LABA Anoro Ellipta demonstrated 1.9x greater lung function improvement from baseline vs the ICS/LABA Seretide Accuhaler 50µg/500µg on Day 84 (p<0.001).3

166mL vs 87mL LS mean change from baseline in weighted mean FEV1 over 0 – 24 hrs for Anoro Ellipta vs Seretide Accuhaler 50µg/500µg on Day 84 (treatment difference 80mL, 95% CI: 0.046-0.113; p<0.001).3

Chart adapted from Singh D et al. 2015.3

In a 12-week, double-blind trial of Anoro Ellipta (n=358) vs Seretide Accuhaler 50μg/500μg (n=358) there were no unexpected safety findings.3-5

The most common AEs occurring in ≥3% of patients in both groups were headache, nasopharyngitis, back pain and dysphonia.3-5 Please consult the SmPC for more information.

Why is ICS/LABA not encouraged in COPD?

ICS containing regimens have a negligible therapeutic effect when eosinophils count <100 cells/µL, and are often associated with an increased incidence of pneumonia1,6,7

84.5% of patients continue to experience COPD symptom burden, despite treatment with an ICS/LABA8

(n=464/549). Symptom burden defined as CAT score ≥10. Data from COPD patients in SPRINT, an observational study.8

Anoro Ellipta and Seretide Accuhaler 50µg/500µg should be used with caution in patients with severe cardiovascular disease and/or heart rhythm abnormalities.4.5

Seretide Accuhaler 50µg/500µg, in line with other ICS-containing medicines shows on increased risk of pneumonia5

Seretide Accuhaler 50µg/500µg should be used with caution in patients with diabetes mellitus, thyrotoxicosis, uncorrected hypokalemia or patient predisposed to low level of serum potassium.5

Paradoxical Bronchospasm may occur after Seretide dosing.5

Not all cautions listed here.

Please consult the respective SmPC for more information4,5

Click for Anoro Ellipta (umeclidinium/vilanterol) prescribing information ANORO ELLIPTA is indicated as a maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease (COPD)
Click for Seretide Accuhaler 50/500 (salmeterol xinafoate/fluticasone propionate) prescribing information SERETIDE 500 Accuhaler (50 micrograms salmeterol and 500 micrograms fluticasone propionate) is indicated for the symptomatic treatment of patients with COPD, with a FEV1 <60% predicted normal (pre-bronchodilator) and a history of repeated exacerbations, who have significant symptoms despite regular bronchodilator therapy.
Click here for Relvar Ellipta 92/22mcg (fluticasone furoate/vilanterol) prescribing information. RELVAR ELLIPTA (92 micrograms fluticasone furoate and 22 micrograms vilanterol) is indicated for the symptomatic treatment of adult patients with COPD with a FEV1 <70% predicted normal (post-bronchodilator) and an exacerbation history, despite regular bronchodilator therapy.
Click here for Incruse Ellipta (umeclidinium bromide) prescribing information. INCRUSE ELLIPTA (umeclidinium bromide) is indicated as a maintenance bronchodilator treatment to relieve symptoms in adult patients with COPD.

Anoro Ellipta was developed in collaboration with INNOVIVA

INNOVIVA

Abbreviations:

AE: adverse event; CAT, COPD Assessment Test; COPD, Chronic Obstructive Pulmonary Disease; GOLD, Global Initiative for Chronic Obstructive Lung Disease; ICS, inhaled corticosteroids, LABA, long-acting beta agonist; LAMA, long-acting muscarinic antagonist; mMRC, Modified Medical Research Council; NICE, National Institute for Health and Care Excellence

References:

  1. GOLD. Global Strategy for the Diagnosis, Management and Prevention of COPD. 2025 Report.
  2. COPD in over 16s: diagnosis and management NICE guideline [NG115]. Last updated: July 2019. Available from: https://www.nice.org.uk/guidance/ngll5.
  3. Singh D et al. BMC pulmonary medicine 2015;15;1-12.
  4. Anoro Ellipta (umeclidinium bromide/vilanterol) Summary of Product Characteristics.
  5. Seretide Accuhaler (fluticasone propionate/salmeterol) Summary of Product Characteristics
  6. Garcia M et al. Am J Resp Crit Care Med 2020;201(9):1078-1085.
  7. Trelegy Ellipta (Fluticasone furoate/umeclidinium/vilanterol) Summary of Product Characteristics.
  8. Roche N; npj Primary Care Respiratory Medicine; 2020 ;30;1-7.

 Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/ or search for MHRA Yellowcard in the Google Play or Apple App store. Adverse events should also be reported to GSK on 0800 221 441 or UKSafety@gsk.com.

March 2025 | PM-GB-UCV-WCNT-240008 (V1.0)

Welcome to GSKpro UK

For UK healthcare professionals - information on GSK's medicines and vaccines, educational resources and more.

I’m a UK healthcare professional

Important notice: this site is intended for UK healthcare professionals. By entering this site, you are confirming that you are a UK healthcare professional. This site contains promotional information.

I’m a member of the UK public

This site is intended for members of the UK public, patients and their carers.

   February 2025 | PM-GB-NA-WCNT-200006 (V8.0)

Open cookie banner
Hide cookie banner