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https://www.readbyqxmd.com/read/28767773/long-acting-muscarinic-antagonists-vs-long-acting-%C3%AE-2-agonists-in-copd-exacerbations-a-systematic-review-and-meta-analysis
#1
Israel Silva Maia, Mariângela Pimentel Pincelli, Victor Figueiredo Leite, João Amadera, Anna Maria Buehler
Objective: To determine whether long-acting muscarinic antagonists (LAMAs) provide superior therapeutic effects over long-acting β2 agonists (LABAs) for preventing COPD exacerbations. Methods: This was a systematic review and meta-analysis of randomized clinical trials involving patients with stable, moderate to severe COPD according to the Global Initiative for Chronic Obstructive Lung Disease criteria, treated with a LAMA (i.e., tiotropium bromide, aclidinium, or glycopyrronium), followed for at least 12 weeks and compared with controls using a LABA in isolation or in combination with a corticosteroid...
July 31, 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28757318/new-treatment-option-for-copd-two-long-acting-bronchodilators-in-a-single-metered-dose-inhaler
#2
REVIEW
Timothy H Self, Samantha Ellingson
Combination long-acting inhaled bronchodilators are central to the management of moderate to very severe chronic obstructive pulmonary disease (COPD) patients. Glycopyrrolate is a long-acting muscarinic antagonist (LAMA), and formoterol fumarate is a long-acting beta2 agonist (LABA). In randomized controlled trials, this LAMA/LABA combination in a metered dose inhaler (MDI) was shown to be effective in improving pulmonary function and quality of life. Clinicians now have the availability of three delivery systems for LAMA/LABA therapy, including MDI, dry-powder inhaler, and Soft Mist inhaler...
July 27, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28745522/pharmacological-characterization-of-the-interaction-between-tiotropium-and-olodaterol-administered-at-5-5-concentration-ratio-in-equine-bronchi
#3
Luigino Calzetta, Paola Rogliani, Maurizio Mattei, Pietro Alfonsi, Giuseppe Cito, Elena Pistocchini, Mario Cazzola, Maria Gabriella Matera
Equine airways represent a suitable ex vivo model to study the functional impact of pharmacological treatments on human chronic obstructive pulmonary disorders, such as asthma and chronic obstructive pulmonary disease (COPD). We aimed to characterize the pharmacological interaction between the long-acting muscarinic antagonist (LAMA) tiotropium and the long-acting β2-agonist (LABA) olodaterol in equine airways. The effect of tiotropium and olodaterol, administered alone and in combination at the ratio of concentrations reproducing ex vivo the concentration-ratio delivered by the currently available fixed-dose combination (FDC) (5:5), was investigated on the cholinergic contractile tone induced by the parasympathetic activation of equine isolated airways...
July 26, 2017: COPD
https://www.readbyqxmd.com/read/28732830/impact-of-laba-lama-combination-on-exercise-endurance-and-lung-hyperinflation-in-copd-a-pair-wise-and-network-meta-analysis
#4
REVIEW
Luigino Calzetta, Josuel Ora, Francesco Cavalli, Paola Rogliani, Denis E O'Donnell, Mario Cazzola
BACKGROUND: The ability to exercise is an important clinical outcome in COPD, and the improvement in exercise capacity is recognized to be an important goal in the management of COPD. Therefore, since the current interest in the use of bronchodilators in COPD is gradually shifting towards the dual bronchodilation, we carried out a meta-analysis to evaluate the impact of LABA/LAMA combination on exercise capacity and lung hyperinflation in COPD. METHODS: RCTs were identified after a search in different databases of published and unpublished trials...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28720132/efficacy-and-safety-of-direct-switch-to-indacaterol-glycopyrronium-in-patients-with-moderate-copd-the-crystal-open-label-randomised-trial
#5
Claus F Vogelmeier, Mina Gaga, Maryam Aalamian-Mattheis, Timm Greulich, Jose M Marin, Walter Castellani, Vincent Ninane, Stephen Lane, Xavier Nunez, Francesco Patalano, Andreas Clemens, Konstantinos Kostikas
BACKGROUND: Dual bronchodilation combining a long-acting β2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) is the preferred choice of treatment recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 guidelines for the management of patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). The once-daily (q.d.) fixed-dose combination (FDC) of LABA, indacaterol 110 μg and LAMA, glycopyrronium 50 μg (IND/GLY 110/50 μg q...
July 18, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28716723/pharmacological-characterization-of-the-interaction-between-umeclidinium-and-vilanterol-in-human-bronchi
#6
Luigino Calzetta, Paola Rogliani, Francesco Facciolo, Erino Rendina, Mario Cazzola, Maria Gabriella Matera
The long-acting β2-agonist (LABA) / long-acting muscarinic antagonist (LAMA) fixed dose combination (FDC) therapy represents the cornerstone for the treatment of chronic obstructive pulmonary disease (COPD). Nevertheless, conflicting clinical findings still exist on the real benefit of the LABA/LAMA FDCs. Therefore, we investigated whether combining the LABA vilanterol with the LAMA umeclidinium may induce synergistic bronchorelaxant effect in isolated airways. The effect of umeclidinium and vilanterol, administered alone, in combination at the ratio of concentrations reproducing the doses delivered by Anoro(®) Ellipta(®) (55:22), or at isoeffective low concentrations, was investigated on the cholinergic contractile tone induced by the parasympathetic activation of human isolated airways...
July 14, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28694698/maintenance-therapy-in-copd-time-to-phase-out-ics-and-switch-to-the-new-lama-laba-inhalers
#7
REVIEW
Syed Mohammad Tariq, Enson C Thomas
Long-term maintenance therapy for COPD is evolving rapidly. Dual bronchodilation with new long-acting muscarinic antagonist and long-acting beta-agonist (LAMA/LABA) fixed dose combination inhalers were introduced over the past 2 years. In clinical trials, these inhalers significantly improved lung function (trough forced expiratory volume in 1 second), patient-reported outcomes, and quality of life measures compared with placebo, their respective monocomponents, and tiotropium. The recorded adverse events of these new inhalers were also similar to those of their monocomponents or placebo...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28694697/double-bronchodilation-in-chronic-obstructive-pulmonary-disease-a-crude-analysis-from-a-systematic-review
#8
Jose Luis Lopez-Campos, Carmen Calero-Acuña, Eduardo Márquez-Martín, Esther Quintana Gallego, Laura Carrasco-Hernández, Maria Abad Arranz, Francisco Ortega Ruiz
OBJECTIVE: The combination of a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA) in a single inhaler is a viable treatment option for patients with chronic obstructive pulmonary disease (COPD). Here, we systematically review the current knowledge on double bronchodilation for the treatment of COPD, with a specific focus on its efficacy versus placebo and/or monotherapy bronchodilation. METHODS: A systematic review of clinical trials investigating LABA/LAMA combination therapies was conducted...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28684905/a-retrospective-study-to-assess-clinical-characteristics-and-time-to-initiation-of-open-triple-therapy-among-patients-with-chronic-obstructive-pulmonary-disease-newly-established-on-long-acting-mono-or-combination-therapy
#9
Douglas Mapel, François Laliberté, Melissa H Roberts, Susan R Sama, Devi Sundaresan, Dominic Pilon, Patrick Lefebvre, Mei Sheng Duh, Jeetvan Patel
INTRODUCTION: An incremental approach using open-triple therapy may improve outcomes in patients with chronic obstructive pulmonary disease (COPD). However, there is little sufficient, real-world evidence available identifying time to open-triple initiation. METHODS: This retrospective study of patients with COPD, newly initiated on long-acting muscarinic antagonist (LAMA) monotherapy or inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combination therapy, assessed baseline demographics, clinical characteristics, and exacerbations during 12 months prior to first LAMA or ICS/LABA use...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28677404/risk-of-cardiovascular-and-cerebrovascular-events-in-copd-patients-treated-with-long-acting-%C3%AE-2-agonist-combined-with-a-long-acting-muscarinic-or-inhaled-corticosteroid
#10
Jennifer C Samp, Min J Joo, Glen T Schumock, Gregory S Calip, A Simon Pickard, Todd A Lee
BACKGROUND: The recent approval of several fixed-dose combination long-acting β2-agonist (LABA) and long-acting muscarinic antagonist (LAMA) products has increased the use of dual bronchodilators in the treatment of chronic obstructive pulmonary disease (COPD). Understanding the comparative safety of this combination is important for informing treatment decisions. OBJECTIVE: To compare the risk of cardiovascular and cerebrovascular (CCV) events associated with LABA/LAMA compared with a combination of LABA and inhaled corticosteroid (ICS)...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28670116/treatment-trends-in-patients-with-asthma-copd-overlap-syndrome-in-a-copd-cohort-findings-from-a-real-world-survey
#11
Bo Ding, Mark Small
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is an increasingly recognized phenotype. Few randomized clinical trials have been conducted in patients with ACOS; therefore, scientific evidence concerning ACOS is scarce and a therapeutic approach remains unclear. The aim of this study was to evaluate current treatment trends for patients with ACOS, identified as those with a dual definition of asthma and COPD, in a real-world COPD cohort. METHODS: Data were analyzed from patients with asthma and COPD in the USA, France, Germany, Italy, Spain, and the UK who participated in the 2012 and 2013 Adelphi Respiratory Disease Specific Programmes (DSPs)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28654201/long-acting-beta2-agonists-versus-long-acting-muscarinic-antagonists-in-patients-with-stable-copd-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Wang-Chun Chen, Chi-Hsien Huang, Chau-Chyun Sheu, Inn-Wen Chong, Kuo-An Chu, Yung-Che Chen, Jong-Rung Tsai, Cheng-Hung Lee, Yu-Feng Wei
Several long-acting bronchodilators have been developed and are widely used as first-line treatment in patients with stable chronic obstructive pulmonary disease (COPD). However, the initial choice of therapy is still uncertain. The aim of this study was to examine the clinical efficacy and safety of long-acting muscarinic antagonist (LAMA) and long-acting beta2-agonist (LABA) in patients with stable COPD. We searched several databases and manufacturers' websites to identify relevant randomized clinical trials for meta-analysis...
June 27, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#13
REVIEW
Marc Miravitlles, Antonio Anzueto, José R Jardim
The natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilization; reduced quality of life; and increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations (GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA)/LAMA combination, respectively, as preferred initial treatments...
June 20, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28626506/impact-of-nonadherence-to-inhaled-corticosteroid-laba-therapy-on-copd-exacerbation-rates-and-healthcare-costs-in-a-commercially-insured-us-population
#14
Jill R Davis, Bingcao Wu, David M Kern, Ozgur Tunceli, Kathleen M Fox, John Horton, Randall F Legg, Frank Trudo
BACKGROUND: Evidence of poor patient adherence to medications for chronic obstructive pulmonary disease (COPD) is well-documented, but its impact on disease exacerbation rates and associated healthcare costs remains unclear. OBJECTIVE: To assess the association between adherence levels to different inhaled corticosteroid/long-acting ß2-adrenergic agonist (LABA) and COPD exacerbation rates and costs in a commercially insured population. METHODS: In this observational cohort study, patients with COPD (aged ≥40 years) who were treatment-naïve to inhaled corticosteroid/LABA and were initiating budesonide plus formoterol or fluticasone plus salmeterol between March 1, 2009, and January 31, 2014, were identified in a national representative claims database and were followed for up to 12 months...
April 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28579771/a-cross-sectional-survey-of-current-treatment-and-symptom-burden-of-patients-with-copd-consulting-for-routine-care-according-to-gold-2014-classifications
#15
Bo Ding, Mark Small, Ulf Holmgren
BACKGROUND: As part of the Respiratory Disease Specific Program (DSP) conducted to provide observations of clinical practice from a physician and matched patient viewpoint, this study aimed to establish how patients with COPD are treated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification system and to quantify the symptom burden. METHODS: Data were obtained from the Respiratory DSP, a cross-sectional survey of patients with a diagnosis of COPD consulting for routine care in France, Germany, Italy, Spain, the UK, and the USA during the third quarter of 2013...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28578989/-changing-patterns-of-medication-prescription-for-copd-patients-in-france-impact-of-long-acting-muscarinic-antagonists-availability
#16
G Jébrak, P-R Burgel, D Caillaud, G Deslée, G Brinchault, P Chanez, I Court-Fortune, R Escamilla, P Nesme-Meyer, C Pinet, T Perez, J-L Paillasseur, N Roche
INTRODUCTION: We studied the pattern changes over time of medication prescriptions for COPD and their conformity with French and international recommendations using data from patients in the prospective French cohort "Initiatives BPCO". METHOD: Eight hundred and forty-six patients have been included during a first period from August, 2001 till May 2006 (n=425) and a second period from June, 2006 till June, 2012 (n=421). The pivotal date was based on the tiotropium availability in France...
May 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28558829/which-bronchodilator-reversibility-criteria-can-predict-severe-acute-exacerbation-in-chronic-obstructive-pulmonary-disease-patients
#17
Junghyun Kim, Woo Jin Kim, Chang-Hoon Lee, Sang Haak Lee, Myung-Goo Lee, Kyeong-Cheol Shin, Kwang Ha Yoo, Ji-Hyun Lee, Seong Yong Lim, Ju Ock Na, Hun-Gyu Hwang, Yoonki Hong, Myoung Nam Lim, Chul-Gyu Yoo, Ki Suck Jung, Sang-Do Lee
BACKGROUND: It is unclear whether various bronchodilator reversibility (BDR) criteria affect the prognosis of chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate the impact of positive BDR defined according to various BDR criteria on the risk of severe acute exacerbation (AE) in COPD patients. METHODS: Patients from four prospective COPD cohorts in South Korea who underwent follow-up for at least 1 year were enrolled in this study...
May 30, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28537001/study-design-of-vesuto-%C3%A2-efficacy-of-tiotropium-olodaterol-on-lung-hyperinflation-exercise-capacity-and-physical-activity-in-japanese-patients-with-chronic-obstructive-pulmonary-disease
#18
Masakazu Ichinose, Yoshiaki Minakata, Takashi Motegi, Jun Ueki, Tetsuo Seki, Tatsuhiko Anzai, Ayako Takizawa, Lars Grönke, Kazuto Hirata
INTRODUCTION: The superiority of tiotropium/olodaterol is demonstrated in improvement of lung function, dyspnea, lung hyperinflation, and quality of life compared with either monotherapy in patients with chronic obstructive pulmonary disease (COPD). Japanese Respiratory Society Guidelines for COPD management include improvement of exercise tolerance and daily physical activity as the treatment goals; however, there is limited evidence in Japanese patients with COPD. METHODS: A protocol is developed for the VESUTO(®) study that investigates the efficacy of tiotropium/olodaterol fixed-dose combination (FDC) compared with tiotropium alone on inspiratory capacity (IC, volume from functional residual capacity to total lung capacity), exercise capacity, and daily physical activity in Japanese patients with COPD...
July 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28536251/concurrent-use-of-long-acting-bronchodilators-in-copd-and-the-risk-of-adverse-cardiovascular-events
#19
Samy Suissa, Sophie Dell'Aniello, Pierre Ernst
The cardiovascular risk of concurrently using long-acting β2-agonists (LABAs) and anticholinergics (LAMAs) in COPD is uncertain. We assessed the comparative cardiovascular and cerebrovascular safety of adding a second long-acting bronchodilator in patients with COPD.We identified a cohort of COPD patients, new users of LABA or the LAMA tiotropium during 2002-2012, from the UK Clinical Practice Research Datalink. Using high-dimensional propensity scores, each patient adding a second bronchodilator was matched with a patient who remained on monotherapy...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28527920/emerging-bronchoscopic-treatments-for-chronic-obstructive-pulmonary-disease
#20
REVIEW
Wouter H van Geffen, Huib A M Kerstjens, Dirk-Jan Slebos
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by pathophysiological factors including airflow limitation, hyperinflation and reduced gas exchange. Treatment consists of lifestyle changes, lung rehabilitation and pharmacological therapies such as long acting beta-2-agonists (LABA) and long acting muscarinic antagonists (LAMA). More recently bronchoscopic treatments are emerging for COPD. Among them endobronchial valves(EBV) and endobronchial coils (EBC), next to endobronchial stents, sclerosing agents, targeted lung denervation and liquid nitrogen metered cryospray...
May 17, 2017: Pharmacology & Therapeutics
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