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Laba/lama fdc in copd

David Price, Anders Østrem, Mike Thomas, Tobias Welte
Several fixed-dose combinations (FDCs) of long-acting bronchodilators (a long-acting muscarinic antagonist [LAMA] plus a long-acting β2-agonist [LABA]) are available for the treatment of COPD. Studies of these FDCs have demonstrated substantial improvements in lung function (forced expiratory volume in 1 second) in comparison with their respective constituent monocomponents. Improvements in patient-reported outcomes (PROs), such as symptoms and health status, as well as exacerbation rates, have been reported compared with a LABA or LAMA alone, but results are less consistent...
2017: International Journal of Chronic Obstructive Pulmonary Disease
Eric Derom, Guy G Brusselle, Guy F Joos
Tiotropium-olodaterol, formulated in the Respimat soft-mist inhaler, is an inhaled fixed-dose combination (FDC) of a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA), commercialized under the name of Spiolto or Stiolto. The efficacy of tiotropium-olodaterol 5-5 μg once daily in adult patients with COPD was documented in eleven large, multicenter trials of up to 52 weeks duration. Tiotropium-olodaterol 5-5 μg not only improved spirometric values to a significantly greater extent than placebo but also resulted in statistically significant beneficial effects on dyspnea, markers of hyperinflation, use of rescue medication, health-related quality of life, and exercise endurance...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Abigail Tebboth, Andrew Ternouth, Nuria Gonzalez-Rojas
OBJECTIVE: The aim of this study is to assess the cost-effectiveness of other long-acting muscarinic antagonist + long-acting β2 agonist combinations in comparison with Spiolto(®) Respimat(®) (tiotropium + olodaterol fixed-dose combination [FDC]) for maintenance treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease. METHODS: A previously published individual-level Markov model was adapted for the perspective of the UK health care system, in line with recommendations from the National Institute for Health and Care Excellence...
2016: ClinicoEconomics and Outcomes Research: CEOR
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
Paolo Montuschi, Mario Malerba, Giuseppe Macis, Nadia Mores, Giuseppe Santini
Combining individual drugs in a single inhaler is the most convenient way to deliver triple therapy. A long-acting muscarinic receptor antagonist (LAMA) added to an inhaled corticosteroid (ICS)/long-acting β2-adrenoceptor agonist (LABA) fixed-dose combination (FDC) can improve efficacy of pharmacological treatment of patients with chronic obstructive pulmonary disease (COPD). New inhaled ICS/LABA/LAMA FDCs, including fluticasone furoate/vilanterol/umeclidinium, budesonide/formoterol/glycopyrronium and beclometasone/formoterol/glycopyrronium, are in Phase III of clinical development for COPD...
July 21, 2016: Drug Discovery Today
Ivan Demin, Christian Bartels, Gordon Graham, Bruno Bieth, Aurélie Gautier, Hanns-Christian Tillmann, Romain Sechaud
OBJECTIVE: Indacaterol/glycopyrronium (IND/GLY) is a fixed-dose combination (FDC) of indacaterol, an inhaled long-acting β2-agonist (LABA), and glycopyrronium, an inhaled long-acting muscarinic antagonist (LAMA), developed as a maintenance bronchodilator treatment for patients with chronic obstructive pulmonary disease (COPD). A population pharmacokinetic (PK) analysis was performed to describe the PK profiles of indacaterol and glycopyrronium following the twice daily (b.i.d.) and once daily (o...
June 2016: International Journal of Clinical Pharmacology and Therapeutics
Luigino Calzetta, Paola Rogliani, Maria Gabriella Matera, Mario Cazzola
BACKGROUND: The wide availability of long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) fixed-dose combinations (FDCs) in the absence of head-to-head comparative pragmatic trials makes it difficult to choose which combination should be used. Therefore, we carried out a systematic review with meta-analysis that incorporated the data from trials lasting at least 3 months to evaluate the effectiveness of LAMA/LABA FDCs for COPD treatment. METHODS: Randomized controlled trials were identified by searching different databases of published and unpublished trials...
May 2016: Chest
Luigino Calzetta, Chiara Ciaprini, Ermanno Puxeddu, Mario Cazzola
Patients suffering from COPD not controlled by a single bronchodilator should be given two bronchodilators with different mechanisms of action. Addition of a LABA to a LAMA induces a larger bronchodilation than that obtained with the LAMA as monotherapy and also improves many patient-reported outcomes. Since the clinical-functional sign regarding simultaneous use of tiotropium, which is still the dominant LAMA, and olodaterol was very strong, the combination of these two bronchodilators has been developed as FDC delivered via a single inhaler (Respimat) with the aim of simplifying the treatment regimen and improving patient adherence to treatment...
March 22, 2016: Expert Review of Respiratory Medicine
Gary T Ferguson, Matjaž Fležar, Stephanie Korn, Lawrence Korducki, Lars Grönke, Roger Abrahams, Roland Buhl
INTRODUCTION: The once-daily long-acting muscarinic antagonist (LAMA) tiotropium and once-daily long-acting β2-agonist (LABA) olodaterol have been studied as a once-daily fixed-dose combination (FDC) in patients with chronic obstructive pulmonary disease (COPD). Two large, 52-week, double-blind, parallel-group studies in patients with moderate-very severe COPD demonstrated that tiotropium + olodaterol significantly improved lung function and symptoms versus the monocomponents. This post hoc analysis determined effects on lung function by prior LAMA or LABA maintenance treatment and initial disease severity...
June 2015: Advances in Therapy
Maria Gabriella Matera, Paola Rogliani, Mario Cazzola
INTRODUCTION: The combination of two bronchodilators with different mechanisms of action to treat patients with chronic obstructive pulmonary disease (COPD) is an established medical practice, but the dissimilarities in the onset and duration of action of long-acting β2-agonists (LABA) and long-acting muscarinic agents (LAMA) and differences in the devices used for the delivery of these drugs make free combinations uncomfortable and unpredictable, especially if focused on adherence to prescribed treatment...
May 2015: Expert Opinion on Pharmacotherapy
Morven Wilkie, Simon Finch, Stuart Schembri
Chronic obstructive pulmonary disease (COPD) guidelines suggest using inhaled corticosteroids (ICS) in patients with severe airflow limitation or those at high risk of exacerbations. This recommendation is based on evidence demonstrating that ICS, especially when prescribed in fixed-dose combinations (FDC) with long-acting β2 agonists (LABA), improve quality of life (QoL), decrease exacerbations and hospitalisations, and have been associated with a trend towards a reduction in all-cause mortality. Audit shows that routine prescribing practice frequently uses inhaler therapies outside current guidelines recommendations; severe to very severe disease constitutes about 20% of all COPD patients, but up to 75% of COPD patients are prescribed an ICS, with significant numbers given ICS/LABA as first-line maintenance therapy...
2015: COPD
Dave Singh
Fixed dose combination (FDC) dual bronchodilators that co-administer a long acting β2 -adrenoceptor agonist (LABA) and a long acting muscarinic antagonist (LAMA) are a new class of inhaled treatment for chronic obstructive pulmonary disease (COPD). This review focuses on the clinical evidence for the benefit of LABA/LAMA FDCs compared with monocomponent treatments, and also compared with active comparators that are widely used for the treatment of COPD, namely tiotropium and salmeterol-fluticasone. Novel FDC dual bronchodilators include QVA149 and umeclidinium/vilanterol (UMEC/VI)...
May 2015: British Journal of Clinical Pharmacology
Gregory J Feldman, Anton Edin
The defining feature of chronic obstructive pulmonary disease (COPD) is progressive airflow limitation that causes air trapping and hyperinflation. The increasing hyperinflation results in dyspnea along with associated inability to engage in the activities of daily living. The American Thoracic Society (ATS), European Respiratory Society (ERS) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines all place bronchodilators as the foundation of pharmacological management of COPD...
December 2013: Therapeutic Advances in Respiratory Disease
Fernie Penning-van Beest, Myrthe van Herk-Sukel, Rupert Gale, Jan-Willem Lammers, Ron Herings
BACKGROUND: Long-acting muscarinic antagonists (LAMA), long-acting β2-agonists (LABA) and fixed dose combinations (FDC) of inhaled corticosteroids (ICS) and LABA are used as inhaled maintenance therapies for COPD. OBJECTIVE: To estimate persistence rates from dispensing patterns of long-acting inhaled drugs for COPD. METHODS: From the PHARMO-database, COPD patients starting LAMA, LABA or LABA-ICS FDC between 2002 and 2006 were selected. Persistence with the initial as well as with any long-acting inhaled drug was determined, defined as time between start and stop of initial/any therapy, allowing ≤ 60-days gaps between refills...
February 2011: Respiratory Medicine
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