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https://www.readbyqxmd.com/read/27922741/how-do-dual-long-acting-bronchodilators-prevent-exacerbations-of-chronic-obstructive-pulmonary-disease
#1
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
#2
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/27852080/prevalence-of-small-airway-dysfunction-among-copd-patients-with-different-gold-stages-and-its-role-in-the-impact-of-disease
#3
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
#4
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
#5
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/27808096/first-maintenance-therapy-for-copd-in-the-uk-between-2009-and-2012-a-retrospective-database-analysis
#6
David Price, Marc Miravitlles, Ian Pavord, Mike Thomas, Jadwiga Wedzicha, John Haughney, Katsiaryna Bichel, Daniel West
Clinical guidelines recommend long-acting bronchodilators as first maintenance therapy for chronic obstructive pulmonary disease (COPD), with inhaled corticosteroids (ICS) reserved for patients with more severe disease and exacerbations. The aim of this analysis was to examine real-life prescribing of first maintenance therapy for COPD in the UK. Data were extracted from the UK Optimum Patient Care Research Database for patients with a first prescription for COPD maintenance therapy between 2009 and 2012 and a diagnosis of COPD at or before the date of the first prescription for COPD maintenance therapy...
November 3, 2016: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/27790275/the-role-of-bronchodilators-in-preventing-exacerbations-of-chronic-obstructive-pulmonary-disease
#7
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
#8
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
#9
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
#10
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/27634637/laba-lama-combinations-instead-of-laba-ics-combinations-may-prevent-or-delay-exacerbations-of-copd-in-some-patients
#11
Mario Cazzola, Paola Rogliani
No abstract text is available yet for this article.
September 15, 2016: Evidence-based Medicine
https://www.readbyqxmd.com/read/27613392/pharmacological-strategies-to-reduce-exacerbation-risk-in-copd-a-narrative-review
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27474505/dtb-select-8-august-2016
#15
(no author information available yet)
▼Canagliflozin and risk of lower limb amputation ● Antidepressants and young people ● Biological interventions for fatigue in RA ● Body shape in early and midlife linked to mortality ● COPD: LABA plus LAMA versus LABA plus ICS ● Safety warning for Nexplanon (etonogesterel) contraceptive implants ● Incorporating long-term prognosis into the care of older adults ● Impact of moderate-to-vigorous physical activity on cancer risk.
August 2016: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/27452453/triple-inhaled-therapy-for-chronic-obstructive-pulmonary-disease
#16
REVIEW
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
https://www.readbyqxmd.com/read/27418551/a-phase-iii-randomised-controlled-trial-of-single-dose-triple-therapy-in-copd-the-impact-protocol
#17
Steven J Pascoe, David A Lipson, Nicholas Locantore, Helen Barnacle, Noushin Brealey, Rajat Mohindra, Mark T Dransfield, Ian Pavord, Neil Barnes
Patients with symptomatic advanced chronic obstructive pulmonary disease (COPD) who experience recurrent exacerbations are particularly at risk of poor outcomes and present a significant burden on healthcare systems. The relative merits of treating with different inhaled combination therapies e.g. inhaled corticosteroids (ICS)/long-acting β2-agonist (LABA), LABA/long-acting muscarinic antagonists (LAMA), ICS/LABA/LAMA, in this patient group are poorly understood, as is reflected in current guidelines. The InforMing the PAthway of COPD Treatment (IMPACT) study will evaluate the efficacy and safety of fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI) versus FF/VI or UMEC/VI over a 52-week treatment period...
August 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27334739/the-effect-of-umeclidinium-added-to-inhaled-corticosteroid-long-acting-%C3%AE-2-agonist-in-patients-with-symptomatic-copd-a-randomised-double-blind-parallel-group-study
#18
Ana R Sousa, John H Riley, Alison Church, Chang-Qing Zhu, Yogesh S Punekar, William A Fahy
Benefits of triple therapy with a long-acting muscarinic antagonist (LAMA), added to inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA), have been demonstrated. Limited data assessing the efficacy of the LAMA umeclidinium (UMEC) added to ICS/LABA are available. The aim of this study is to evaluate the efficacy and safety of UMEC added to ICS/LABAs in patients with moderate-to-very-severe COPD. This is a multicentre, randomised, double-blind, parallel-group study. Patients were symptomatic (modified Medical Research Council Dyspnoea Scale score ⩾2), despite receiving ICS/LABA (fluticasone propionate/salmeterol (FP/SAL, branded) 500/50 mcg, budesonide/formoterol (BD/FOR, branded) 200/6 mcg or 400/12 mcg, or other ICS/LABAs) ⩾30 days before the run-in (7±2 days)...
June 23, 2016: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/27254954/-role-of-ics-laba-on-copd-treatment
#19
REVIEW
Yoko Shibata
In the treatment of chronic obstructive pulmonary disease (COPD), bronchodilators such as long acting muscarinic antagonist (LAMA) and long acting β agonist(LABA) play key roles for improving respiratory function and symptoms, and reducing risk of exacerbation. However, inhaled corticosteroid (ICS), a key medicine for bronchial asthma, is limitedly used in COPD treatment. Japanese Respiratory Society recommends to use ICS for severe COPD patients who have been frequently exacerbated, because previous clinical studies indicated that ICS reduces exacerbation in moderate to severe COPD patients...
May 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27223863/efficacy-and-safety-of-laba-lama-fixed-dose-combinations-approved-in-the-us-for-the-management-of-copd
#20
Donald Banerji, Donald A Mahler, Nicola A Hanania
INTRODUCTION: Long-acting β2-agonists [LABAs] and long-acting muscarinic antagonists [LAMAs]) are primary therapies for chronic obstructive pulmonary disease (COPD). Despite improvements in lung function and patient-reported outcomes (PROs) with these therapies, there is room to optimize outcomes further. Combined use of LABAs and LAMAs is recommended when symptoms are not improved with a single agent, and LABA/LAMA fixed-dose combinations (FDCs) are at the forefront of drug development in COPD...
July 2016: Expert Review of Respiratory Medicine
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