From 1 March 2021, Atectura® is available on the Pharmaceutical Benefits Scheme (PBS) for the maintenance treatment of asthma in people 12 years of age and older. Atectura® contains the long-acting beta2– agonist (LABA), indacaterol, plus the corticosteroid, mometasone. It is presented as a capsule, the contents of which must be inhaled using the Breezhaler® device supplied in the carton.

The Australian Asthma Handbook advises that, for adult patients already taking an inhaled corticosteroid, the addition of a LABA reduces the risk of exacerbations compared with increasing the corticosteroid dose. The results of the PALLADIUM study support this advice. In this study, medium and high doses of mometasone plus indacaterol demonstrated superior improvements in forced expiratory volume in one second (FEV1) compared to higher doses of mometasone. In addition, high-dose mometasone plus indacaterol was shown to be non-inferior to high-dose fluticasone propionate plus salmeterol in improving FEV1.

Atectura® is available in three mometasone strengths, with each presentation containing 125mcg of indacaterol. Dysphonia and candidiasis were among the most frequent adverse events reported in clinical trials; patients should be advised to rinse their mouth with water after each dose.

References:

  1. Atectura® Breezhaler® (indacaterol/mometasone furoate) Australian approved product information. Macquarie Park: Novartis Pharmaceuticals. Approved July 2020.
  2. National Asthma Council Australia. Australian Asthma Handbook. Version 2.1. National Asthma Council Australia; Melbourne: 2020.
  3. van Zyl-Smit RN, Krüll M, Gessner C, Gon Y, Noga O, Richard A, et al. Once-daily mometasone plus indacaterol versus mometasone or twice-daily fluticasone plus salmeterol in patients with inadequately controlled asthma (PALLADIUM): a randomised, double-blind, triple-dummy, controlled phase 3 study. Lancet Resp Med. 2020; 8(10): P987-99.

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