The following is a summary of “Inhaled Fluticasone Furoate for Outpatient Treatment of Covid-19,” published in the September 2023 issue of Infectious Disease by Boulware et al.

As of 2023, the effectiveness of inhaled glucocorticoids in outpatients with mild-to-moderate COVID-19 is unknown. Researchers performed a retrospective platform trial to assess repurposed medications in outpatients with coronavirus disease 2019 (COVID-19).

They conducted a randomized trial on non-hospitalized adults aged 30 or older who had experienced at least two symptoms of acute infection for no more than 7 days before enrollment. Participants were randomized to inhaled fluticasone furoate (200 μg/day for 14 days) or placebo. The primary outcome assessed was the time it took to achieve sustained recovery, defined as three consecutive days without symptoms. Key secondary outcomes were hospitalization, death by day 28 and urgent care, emergency department visits, and hospitalization, death up to day 28.

The results showed 1,407 enrolled participants, 715 received inhaled fluticasone furoate, and 692 received a placebo. In the analysis, 656 and 621 participants were included. There was no indication that fluticasone furoate led to a faster recovery than placebo (hazard ratio: 1.01; 95% credible interval: 0.91 to 1.12; posterior probability of benefit [defined as a hazard ratio >1]: 0.56). In the fluticasone furoate group, 3.7% (24 participants) had urgent-care or emergency department visits or were hospitalized, compared to 2.1% (13 participants) in the placebo group (hazard ratio: 1.9; 95% credible interval: 0.8 to 3.5). Each group had three hospitalizations, and there were no deaths. Adverse events were rare in both groups.

They concluded that inhaled fluticasone furoate did not shorten the time to recovery from COVID-19 in US outpatients.

Source: nejm.org/doi/full/10.1056/NEJMoa2209421