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Laba and ics in copd

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https://www.readbyqxmd.com/read/27928190/single-center-retrospective-evaluation-of-inhaled-corticosteroid-use-for-chronic-obstructive-pulmonary-disease-exacerbation-patients-receiving-systemic-corticosteroids
#1
Taylor Steuber, Dane Shiltz
Purpose: To determine the frequency of inappropriate inhaled corticosteroid (ICS) therapy when it is prescribed concurrently with systemic corticosteroids; to identify cost-savings potential in the setting of chronic obstructive pulmonary disease (COPD) exacerbations. Methods: Patients admitted to 1 of 8 hospital locations utilizing an integrated electronic health record within the health system for COPD exacerbations treated with systemic corticosteroids (equivalent to at least 30 mg of oral prednisone) between July 1, 2013 and June 30, 2014 were included in a retrospective chart review...
November 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27927039/muscarinic-antagonists-in-early-stage-clinical-development-for-the-treatment-of-asthma
#2
Timothy E Albertson, James A Chenoweth, Jason Y Adams, Mark E Sutter
Parasympathetic neurons utilize the neurotransmitter acetylcholine to modulate and constrict airway smooth muscles at the muscarinic acetylcholine receptor. Inhaled agents that antagonize the muscarinic (M) acetylcholine receptor, particularly airway M3 receptors, have increasing data supporting use in persistent asthma. Areas covered: Use of inhaled long-acting muscarinic antagonists (LAMA) in asthma is explored. The LAMA tiotropium is approved for maintenance in symptomatic asthma patients despite the use of inhaled corticosteroids (ICS), leukotriene receptor antagonists (LTRA) and/or long-acting beta2 agonists (LABA)...
December 7, 2016: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27922741/how-do-dual-long-acting-bronchodilators-prevent-exacerbations-of-chronic-obstructive-pulmonary-disease
#3
Kai M Beeh, Pierre-Regis Burgel, Frits M E Franssen, Jose Luis Lopez-Campos, Stelios Loukides, John R Hurst, Matjaž Fležar, Charlotte Suppli Ulrik, Fabiano Di Marco, Daiana Stolz, Arschang Valipour, Brian Casserly, Björn Ställberg, Konstantinos Kostikas, Jadwiga A Wedzicha
Decreasing the frequency and severity of exacerbations is one of the main goals of treatment for patients with chronic obstructive pulmonary disease (COPD). Several studies have documented that long-acting bronchodilators (LABDs) can reduce exacerbation rate and/or severity, and others have shown that combinations of long-acting 2-adrenergic agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) provide greater reductions in exacerbation frequency than either their monocomponents or LABA/inhaled corticosteroids (LABA/ICS) combinations in patients at low and high risk for these events...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27890625/pharmacological-treatment-optimization-for-stable-chronic-obstructive-pulmonary-disease-proposals-from-the-soci%C3%A3-t%C3%A3-de-pneumologie-de-langue-fran%C3%A3-aise
#4
M Zysman, F Chabot, P Devillier, B Housset, C M Panzini, N Roche
The Société de Pneumologie de Langue Française proposes a decision algorithm on long-term pharmacological COPD treatment. A working group reviewed the literature published between January 2009 and May 2016. This document lays out proposals and not guidelines. It only focuses on pharmacological treatments except vaccinations, smoking cessation treatments and oxygen therapy. Any COPD diagnosis, based on pulmonary function tests, should lead to recommend smoking cessation, vaccinations, physical activity, pulmonary rehabilitation in case of activity limitation, and short-acting bronchodilators...
November 24, 2016: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/27877033/combination-therapy-of-inhaled-steroids-and-long-acting-beta2-agonists-in-asthma-copd-overlap-syndrome
#5
Suh-Young Lee, Hye Yun Park, Eun Kyung Kim, Seong Yong Lim, Chin Kook Rhee, Yong Il Hwang, Yeon-Mok Oh, Sang Do Lee, Yong Bum Park
BACKGROUND: The efficacy of inhaled corticosteroids (ICSs)/long-acting beta2-agonist (LABA) treatment in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) compared to patients with COPD alone has rarely been examined. This study aimed to evaluate the clinical efficacy for the improvement of lung function after ICS/LABA treatment in patients with ACOS compared to COPD alone patients. METHODS: Patients with stable COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27852080/prevalence-of-small-airway-dysfunction-among-copd-patients-with-different-gold-stages-and-its-role-in-the-impact-of-disease
#6
Ernesto Crisafulli, Roberta Pisi, Marina Aiello, Matteo Vigna, Panagiota Tzani, Anna Torres, Giuseppina Bertorelli, Alfredo Chetta
BACKGROUND: In chronic obstructive pulmonary disease (COPD) patients, small-airway dysfunction (SAD) is considered a functional hallmark of disease. However, the exact role of SAD in the clinical presentation of COPD is not yet completely understood; moreover, it is not known whether SAD may have a relationship with the impact of disease. OBJECTIVES: To evaluate the prevalence of SAD among COPD patients categorized by the old and the new GOLD classification and to ascertain whether there is a relationship between SAD and impact of disease measured by the COPD Assessment Test (CAT) questionnaire...
November 17, 2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27830584/inhaled-corticosteroids-with-combination-inhaled-long-acting-beta2-agonists-and-long-acting-muscarinic-antagonists-for-chronic-obstructive-pulmonary-disease
#7
REVIEW
Daniel J Tan, Clinton J White, Julia Ae Walters, E Haydn Walters
BACKGROUND: Management of chronic obstructive pulmonary disease (COPD) commonly involves long-acting bronchodilators including beta-agonists (LABA) and muscarinic antagonists (LAMA). In individuals with persistent symptoms or frequent exacerbations, inhaled corticosteroids (ICS) are also used. LABA and LAMA bronchodilators are now available in single combination inhalers. However, the benefits and risks of adding ICS to combination LABA/LAMA inhalers remains unclear. OBJECTIVES: To assess the effect of adding an inhaled corticosteroid (ICS) to combination long-acting beta₂-agonist (LABA)/long-acting muscarinic antagonist (LAMA) inhalers for the treatment of stable COPD...
November 10, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27819513/can-assessment-of-disease-burden-prior-to-changes-in-initial-copd-maintenance-treatment-provide-insight-into-remaining-unmet-needs-a-retrospective-database-study-in-uk-primary-care
#8
Sarah H Landis, Keele Wurst, Hoa Van Le, Kerina Bonar, Yogesh S Punekar
This retrospective cohort study aimed to assess treatment patterns over 24 months amongst patients with chronic obstructive pulmonary disease (COPD), initiating a new COPD maintenance treatment, and to understand clinical indicators of treatment change. Patients included in the study initiated a long-acting β2-agonist (LABA), a long-acting muscarinic antagonist (LAMA), or a combination of LABA and an inhaled corticosteroid (ICS/LABA) between January 1, 2009, and November 30, 2013, as recorded in the United Kingdom Clinical Practice Research Datalink (UK CPRD)...
November 7, 2016: COPD
https://www.readbyqxmd.com/read/27817816/incidence-of-oral-thrush-in-patients-with-copd-prescribed-inhaled-corticosteroids-effect-of-drug-dose-and-device
#9
P N Richard Dekhuijzen, Maria Batsiou, Leif Bjermer, Sinthia Bosnic-Anticevich, Henry Chrystyn, Alberto Papi, Roberto Rodríguez-Roisin, Monica Fletcher, Lucy Wood, Alessandra Cifra, Joan B Soriano, David B Price
BACKGROUND AND AIMS: Little information is available on real-life occurrence of oral thrush in COPD patients treated with ICS. We investigated oral thrush incidence in COPD patients prescribed FDC ICS/LABA therapies and assessed whether it is modulated by the ICS type, dose, and delivery device. METHODS: We conducted a historical, observational, matched cohort study (one baseline year before and one outcome year after initiation of therapy) using data from the UK Optimum Patient Care Research Database...
November 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27790275/the-role-of-bronchodilators-in-preventing-exacerbations-of-chronic-obstructive-pulmonary-disease
#10
REVIEW
Kai M Beeh
Bronchodilators are the cornerstone of symptomatic chronic obstructive pulmonary disease (COPD) treatment. They are routinely recommended for symptom reduction, with a preference of long-acting over short-acting drugs. Bronchodilators are classified into two classes based on distinct modes of action, i.e., long-acting antimuscarinics (LAMA, once-daily and twice-daily), and long-acting β2-agonists (LABA, once-daily and twice-daily). In contrast to asthma management, evidence supports the efficacy of both classes of long-acting bronchodilators as monotherapy in preventing COPD exacerbations, with greater efficacy of LAMA drugs versus LABAs...
October 2016: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27787715/bifunctional-drugs-for-the-treatment-of-respiratory-diseases
#11
Clive Page, Mario Cazzola
Over the last decade, there has been a steady increase in the use of fixed dose combinations for the treatment of a range of diseases, including cancer, AIDS, tuberculosis and other infectious diseases. It is now evident that patients with asthma or chronic obstructive pulmonary disease (COPD) can also benefit from the use of fixed dose combinations, including combinations of a long-acting β2-agonist (LABA) and an inhaled corticosteroid (ICS), and combinations of LABAs and long-acting muscarinic receptor antagonists (LAMAs)...
October 28, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27787709/muscarinic-receptor-antagonists
#12
Maria Gabriella Matera, Mario Cazzola
Parasympathetic activity is increased in patients with chronic obstructive pulmonary disease (COPD) and asthma and appears to be the major reversible component of airway obstruction. Therefore, treatment with muscarinic receptor antagonists is an effective bronchodilator therapy in COPD and also in asthmatic patients. In recent years, the accumulating evidence that the cholinergic system controls not only contraction by airway smooth muscle but also the functions of inflammatory cells and airway epithelial cells has suggested that muscarinic receptor antagonists could exert other effects that may be of clinical relevance when we must treat a patient suffering from COPD or asthma...
October 28, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27783268/fixed-dose-combination-inhalers
#13
Mario Cazzola, Maria Gabriella Matera
In asthma and chronic obstructive pulmonary disease (COPD), an important step in simplifying management and improving adherence with prescribed therapy is to reduce the dose frequency to the minimum necessary to maintain disease control. Fixed-dose combination (FDC) therapy might enhance compliance by decreasing the number of medications and/or the number of daily doses. Furthermore, they have the potential for enhancing, sensitizing, and prolonging the effects of monocomponents. Combination therapy with an inhaled corticosteroid (ICS) and a long-acting β-agonist (LABA) is considered an important approach for treating patients with asthma and patients with severe COPD who have frequent exacerbations...
October 26, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27730192/cardiac-impact-of-inhaled-therapy-in-the-largest-randomised-placebo-controlled-trial-in-copd-history-have-we-reached-the-summit
#14
Stefan Andreas, Christer Janson, Maarten van den Berge, Lies Lahousse
SUMMIT supports the efficiency and cardiovascular safety of LABA and ICS in COPD patients at cardiovascular risk http://ow.ly/p6Is300ffoc.
April 2016: ERJ Open Research
https://www.readbyqxmd.com/read/27715335/efficacy-and-safety-of-indacaterol-glycopyrronium-ind-gly-versus-salmeterol-fluticasone-in-chinese-patients-with-moderate-to-severe-chronic-obstructive-pulmonary-disease-the-chinese-cohort-from-the-lantern-study
#15
Nanshan Zhong, Changzheng Wang, Xiangdong Zhou, Nuofu Zhang, Michael Humphries, Linda Wang, Francesco Patalano, Donald Banerji
Inhaled indacaterol/glycopyrronium fixed-dose combination (IND/GLY) is approved in over 80 countries, including the EU, Japan, Australia and Switzerland and the US. The LANTERN study evaluated the efficacy of IND/GLY compared with inhaled long-acting β2-agonist (LABA)/inhaled corticosteroid (ICS) or salmeterol/fluticasone (SFC) in patients with moderate-to-severe COPD with a history of ≤1 exacerbation in the previous year. Here we present the efficacy and safety of IND/GLY versus SFC in the Chinese cohort from the LANTERN study...
December 2016: COPD
https://www.readbyqxmd.com/read/27634637/laba-lama-combinations-instead-of-laba-ics-combinations-may-prevent-or-delay-exacerbations-of-copd-in-some-patients
#16
Mario Cazzola, Paola Rogliani
No abstract text is available yet for this article.
September 15, 2016: Evidence-based Medicine
https://www.readbyqxmd.com/read/27623733/can-computed-tomography-and-carbon-monoxide-transfer-coefficient-diagnose-an-asthma-like-phenotype-in-copd
#17
Feisal A Al-Kassimi, Esam H Al-Hamad, Mohammed S Al-Hajjaj, Emad Raddaoui, Abdulaziz H Alzeer, Ahmad A Alboukai, Ali M Somily, Joseph G Cal, Abdalla F Ibrahim, Shaffi A Shaik
BACKGROUND AND OBJECTIVE: Post-mortem and computed tomography (CT) studies indicated that emphysema is a feature of COPD even in the 'blue bloater/chronic bronchitis' type. We aim to test the hypothesis that the non-emphysematous patients are distinct from the main body of COPD and are more akin to asthmatic patients. METHODS: We studied 54 patients with COPD. Emphysema was measured by Goddard's visual scoring of CT scan and the carbon monoxide transfer coefficient (KCO)...
September 13, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27613392/pharmacological-strategies-to-reduce-exacerbation-risk-in-copd-a-narrative-review
#18
REVIEW
Marc Miravitlles, Anthony D'Urzo, Dave Singh, Vladimir Koblizek
Identifying patients at risk of exacerbations and managing them appropriately to reduce this risk represents an important clinical challenge. Numerous treatments have been assessed for the prevention of exacerbations and their efficacy may differ by patient phenotype. Given their centrality in the treatment of COPD, there is strong rationale for maximizing bronchodilation as an initial strategy to reduce exacerbation risk irrespective of patient phenotype. Therefore, in patients assessed as frequent exacerbators (>1 exacerbation/year) we propose initial bronchodilator treatment with a long-acting muscarinic antagonist (LAMA)/ long-acting β2-agonist (LABA)...
September 10, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27592021/systematic-review-and-quality-appraisal-of-cost-effectiveness-analyses-of-pharmacologic-maintenance-treatment-for-chronic-obstructive-pulmonary-disease-methodological-considerations-and-recommendations
#19
Simon van der Schans, Lucas M A Goossens, Melinde R S Boland, Janwillem W H Kocks, Maarten J Postma, Job F M van Boven, Maureen P M H Rutten-van Mölken
BACKGROUND: Worldwide, chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic lung disease with considerable clinical and socioeconomic impact. Pharmacologic maintenance drugs (such as bronchodilators and inhaled corticosteroids) play an important role in the treatment of COPD. The cost effectiveness of these treatments has been frequently assessed, but studies to date have largely neglected the impact of treatment sequence and the exact stage of disease in which the drugs are used in real life...
September 3, 2016: PharmacoEconomics
https://www.readbyqxmd.com/read/27585384/effect-of-roflumilast-and-inhaled-corticosteroid-long-acting-%C3%AE-2-agonist-on-chronic-obstructive-pulmonary-disease-exacerbations-re-2-spond-a-randomized-clinical-trial
#20
Fernando J Martinez, Klaus F Rabe, Sanjay Sethi, Emilio Pizzichini, Andrew McIvor, Antonio Anzueto, Vijay K T Alagappan, Shahid Siddiqui, Ludmyla Rekeda, Christopher J Miller, Sofia Zetterstrand, Colin Reisner, Stephen I Rennard
RATIONALE: Moderate and severe exacerbations are incompletely prevented by maximal inhalation therapy in patients with severe chronic obstructive pulmonary disease. OBJECTIVES: To determine whether roflumilast reduces moderate and/or severe chronic obstructive pulmonary disease exacerbations in patients at risk for exacerbations despite treatment with inhaled corticosteroid/long-acting β2-agonist with or without a long-acting muscarinic antagonist (LAMA). METHODS: In this 52-week, phase 4, double-blind, placebo-controlled RE(2)SPOND (Roflumilast Effect on Exacerbations in Patients on Dual [LABA/ICS] Therapy) trial (NCT01443845), participants aged 40 years or older with severe/very severe chronic obstructive pulmonary disease, chronic bronchitis, two or more exacerbations and/or hospitalizations in the previous year, and receiving inhaled corticosteroid/long-acting β2-agonist with or without LAMA daily for 3 or more months were equally randomized to once-daily roflumilast, 500 μg (n = 1,178), or placebo (n = 1,176)...
September 1, 2016: American Journal of Respiratory and Critical Care Medicine
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