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https://www.readbyqxmd.com/read/28410560/role-of-long-acting-muscarinic-antagonist-long-acting-%C3%AE-2-agonist-therapy-in-chronic-obstructive-pulmonary-disease
#1
Sarah E Petite
OBJECTIVE: To compare the available literature regarding the use of long-acting muscarinic antagonist (LAMA)/long-acting β2 agonists (LABA) and inhaled corticosteroid (ICS)/LABA combination inhaler therapy in chronic obstructive pulmonary disease (COPD) maintenance therapy management. DATA SOURCES: A MEDLINE literature search from database inception to February 2017 was conducted using the search terms chronic obstructive pulmonary disease, adrenergic beta-agonist, muscarinic antagonist, and inhaled corticosteroid...
April 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28395575/safety-of-inhaled-long-acting-anti-muscarinic-agents-in-copd
#2
Nicola A Hanania, Suzanne C Lareau, Barbara P Yawn
Evidence-based guidelines recommend inhaled long-acting anti-muscarinic agents (LAMAs) as first-line maintenance therapy for symptomatic patients with COPD. Several LAMAs are now available for use either as monotherapy or in combination with other COPD medications, including long-acting β2-agonists (LABAs) or inhaled corticosteroids (ICS). The efficacy and long-term safety of these medications have been evaluated in multiple clinical trials and real-life studies. This review evaluates the evidence available on the safety of existing LAMAs alone or in combination with LABAs and ICS in patients with COPD...
April 20, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28389258/role-of-dual-bronchodilators-in-copd-a-review-of-the-current-evidence-for-indacaterol-glycopyrronium
#3
REVIEW
Joachim H Ficker, Klaus F Rabe, Tobias Welte
In this review, we summarize the rationale for combining long-acting bronchodilators in the management of chronic obstructive pulmonary disease (COPD), and the evidence for the long-acting bronchodilator combination indacaterol/glycopyrronium (IND/GLY). Clinical practice guidelines generally recommend the use of long-acting bronchodilators in the treatment of patients with all severities of COPD, either as a first-choice or alternative-choice therapy. Combining classes of long-acting bronchodilators can result in superior improvements in lung function and clinical outcomes compared with bronchodilator monotherapy, as observed in studies of free combinations of long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs)...
April 4, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28360514/laba-lama-combinations-versus-lama-monotherapy-or-laba-ics-in-copd-a-systematic-review-and-meta-analysis
#4
Gustavo J Rodrigo, David Price, Antonio Anzueto, Dave Singh, Pablo Altman, Giovanni Bader, Francesco Patalano, Robert Fogel, Konstantinos Kostikas
BACKGROUND: Randomized controlled trials (RCTs) indicate that long-acting bronchodilator combinations, such as β2-agonist (LABA)/muscarinic antagonist (LAMA), have favorable efficacy compared with commonly used COPD treatments. The objective of this analysis was to compare the efficacy and safety of LABA/LAMA with LAMA or LABA/inhaled corticosteroid (ICS) in adults with stable moderate-to-very-severe COPD. METHODS: This systematic review and meta-analysis (PubMed/MEDLINE, Embase, Cochrane Library and clinical trial/manufacturer databases) included RCTs comparing ≥12 weeks' LABA/LAMA treatment with LAMA and/or LABA/ICS (approved doses only)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28334727/discovering-the-relative-efficacy-of-inhaled-medications-for-chronic-obstructive-pulmonary-disease-multiple-treatment-comparisons
#5
Ying Zhu, Tong Zhang, Haiyan Li, Yang Yang, Qiong Chen, Lei Kong, Bo Tai
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is managed by three major classes of inhaled medications: inhaled corticosteroids (ICS), long-acting Beta 2-agonist (LABA), long-acting muscarinic antagonist (LAMA). Single inhaled medication is usually replaced by combined inhaled medications for efficacy enhancement. However, this practice should be supported by clinical evidence for large-scale implementations. METHODS: The relative efficacy of inhaled medications is determined by three endpoints: changes in the trough forced expiratory volume in 1 second (tFEV1), changes in the St George's Respiratory Questionnaire (SGRQ) score and the proportion of SGRQ responders which represents a reduction in SGRQ total score at week 24 of ≥4...
March 27, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28293106/inhaled-treatment-of-copd-a-delphi-consensus-statement
#6
Vincent Ninane, Jean-Louis Corhay, Paul Germonpré, Wim Janssens, Guy F Joos, Giuseppe Liistro, Walter Vincken, Sandra Gurdain, Evelyne Vanvlasselaer, An Lehouck
BACKGROUND: Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy (2015) provides guidance for the treatment of chronic obstructive pulmonary disease (COPD) with different first-choice options per GOLD category without specification. OBJECTIVES: To evaluate the level of medical experts' consensus on their preferred first-choice treatment within different COPD categories. METHODS: A two-round Delphi Panel consisting of 15 questions was completed by Belgian pulmonologists (n=31) and European (n=10) COPD experts...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28226405/comparative-effectiveness-of-long-acting-beta2-agonist-combined-with-a-long-acting-muscarinic-antagonist-or-inhaled-corticosteroid-in-chronic-obstructive-pulmonary-disease
#7
Jennifer C Samp, Min J Joo, Glen T Schumock, Gregory S Calip, A Simon Pickard, Todd A Lee
INTRODUCTION: Several dual bronchodilator fixed-dose inhaler medications were recently approved for the treatment of chronic obstructive pulmonary disease (COPD). These products combine a long-acting β2 -agonist (LABA) and long-acting muscarinic antagonist (LAMA). In clinical trials, the separate mechanisms of the bronchodilators resulted in improved lung function. COPD treatment guidelines currently recommend combination LABA/LAMA as alternative therapy to combination LABA/inhaled corticosteroid (ICS)...
April 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28203071/long-acting-bronchodilators-with-or-without-inhaled-corticosteroids-and-30-day-readmission-in-patients-hospitalized-for-copd
#8
Raju Bishwakarma, Wei Zhang, Yong-Fang Kuo, Gulshan Sharma
BACKGROUND: The ability of a long-acting muscarinic antagonist (LAMA) and long-acting beta 2 agonists (LABAs; long-acting bronchodilators, LABDs) with or without inhaled corticosteroids (ICSs) to reduce early readmission in hospitalized patients with COPD is unknown. METHODS: We studied a 5% sample of Medicare beneficiaries enrolled in Medicare parts A, B and D and hospitalized for COPD in 2011. We examined prescriptions filled for LABDs with or without ICSs (LABDs±ICSs) within 90 days prior to and 30 days after hospitalization...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28185242/long-acting-muscarinic-antagonist-lama-plus-long-acting-beta-agonist-laba-versus-laba-plus-inhaled-corticosteroid-ics-for-stable-chronic-obstructive-pulmonary-disease-copd
#9
REVIEW
Nobuyuki Horita, Atsushi Goto, Yuji Shibata, Erika Ota, Kentaro Nakashima, Kenjiro Nagai, Takeshi Kaneko
BACKGROUND: Three classes of inhaler medications are used to manage chronic obstructive pulmonary disease (COPD): long-acting beta-agonists (LABA), long-acting muscarinic antagonists (LAMA), and inhaled corticosteroids (ICS). When two classes of medications are required, LAMA plus LABA (LAMA+LABA) and LABA plus ICS (LABA+ICS) are often selected because these combinations can be administered via a single medication device. The previous Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidance recommended LABA+ICS as the first-line treatment for managing stable COPD in high-risk people of categories C and D...
February 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28176893/indacaterol-glycopyrronium-versus-salmeterol-fluticasone-in-asian-patients-with-copd-at-a-high-risk-of-exacerbations-results-from-the-flame-study
#10
Jadwiga A Wedzicha, Nanshan Zhong, Masakazu Ichinose, Michael Humphries, Robert Fogel, Chau Thach, Francesco Patalano, Donald Banerji
BACKGROUND: The FLAME study demonstrated that indacaterol/glycopyrronium (IND/GLY), the fixed-dose combination of a long-acting β2-agonist (LABA, IND) and a long-acting muscarinic antagonist (LAMA, GLY), was superior to salmeterol/fluticasone combination (SFC) in preventing exacerbations in COPD patients with a high risk of exacerbations. In this study, we report a prespecified analysis of the efficacy and safety of IND/GLY versus SFC in Asian patients from the FLAME study. PATIENTS AND METHODS: Patients from Asian centers with moderate-to-very severe COPD and ≥1 exacerbation in the previous year from the 52-week, randomized FLAME study were included...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28140686/role-of-muscarinic-antagonists-in-asthma-therapy
#11
Mario Cazzola, Josuel Ora, Paola Rogliani, Maria Gabriella Matera
Higher parasympathetic tone has been reported in asthmatics. In general, cholinergic contractile tone is increased by airway inflammation associated with asthma. Nevertheless, the role of muscarinic antagonists for the treatment of asthma has not yet been clearly defined. Areas covered: The use of SAMAs and LAMAs in asthma has been examined and discussed according with the published evidence. Particular attention has been given to the large Phase III clinical trial program designed to evaluate the efficacy and safety of tiotropium respimat added to standard treatment in adults, adolescents and children with persistent asthma across the spectrum of asthma severity...
March 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28117615/investigational-beta-2-adrenergic-agonists-for-the-treatment-of-chronic-obstructive-pulmonary-disease
#12
REVIEW
Mario Malerba, Alessandro Radaeli, Paolo Montuschi, Kesavan S Babu, Jaymin B Morjaria
Long-acting bronchodilators are pivotal in the therapeutic management of COPD patients with moderate-to-severe airflow obstruction. New ultra-long-acting β2-agnoists (ultra-LABAs) have been developed, some of which have been licensed for use as monotherapy and/or in combination with other bronchodilators or inhaled corticosteroids, for use in COPD patients with persistent symptoms and worsening airflow limitation. These new agents are faster in onset and have a prolonged duration of action, with a similar safety profile to the traditional twice-daily bronchodilators which may have an impact on patient concordance...
March 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28099820/new-and-developing-non-adrenoreceptor-small-molecule-drugs-for-the-treatment-of-asthma
#13
REVIEW
Neil C Thomson
Inhaled corticosteroids (ICS) alone or in combination with an inhaled long-acting beta2-agonist (LABA) are the preferred long-term treatment for adults and adolescents with symptomatic asthma. Additional drugs include leukotriene-receptor antagonists, slow-release theophylline and the long-acting muscarinic antagonist (LAMA) tiotropium (approved in 2015). There is a need for more effective therapies, as many patients continue to have poorly controlled asthma. Areas covered: New and developing long-acting non-adrenoreceptor synthetic drugs for the treatment of symptomatic chronic asthma despite treatment with an ICS alone or combined with a LABA...
February 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28089081/asthma-chronic-obstructive-pulmonary-disease-overlap-syndrome-literature-review-and-contributions-towards-a-portuguese-consensus
#14
D Araújo, E Padrão, M Morais-Almeida, J Cardoso, F Pavão, R B Leite, A C Caldas, A Marques
INTRODUCTION: Phenotypic overlap between the two main chronic airway pulmonary diseases, asthma and chronic obstructive pulmonary disease (COPD), has been the subject of debate for decades, and recently the nomenclature of asthma-COPD overlap syndrome (ACOS) was adopted for this condition. The definition of this entity in the literature is, however, very heterogeneous, it is therefore important to define how it applies to Portugal. METHODS: A literature review of ACOS was made in a first phase resulting in the drawing up of a document that was later submitted for discussion among a panel of chronic lung diseases experts, resulting in reflexions about diagnosis, treatment and clinical guidance for ACOS patients...
January 6, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/27993284/non-persistence-and-non-adherence-to-long-acting-copd-medication-therapy-a-retrospective-cohort-study-based-on-a-large-german-claims-dataset
#15
Sabrina Mueller, Thomas Wilke, Benno Bechtel, Yogesh Suresh Punekar, Karen Mitzner, J Christian Virchow
OBJECTIVES: The main objectives of this study, based on a large cohort of German COPD patients, were to assess the level of non-persistence (NP) and non-adherence (NA) with long-acting COPD inhaler treatment and to describe factors that may be associated with NP and NA. METHODS: This was a retrospective cohort analysis based on claims data provided by a German statutory health insurance fund (years 2010-2012). NP was analyzed for treatment-naïve patients only; it was defined as a gap of >90 days in medication availability...
January 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/27927039/muscarinic-antagonists-in-early-stage-clinical-development-for-the-treatment-of-asthma
#16
REVIEW
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)...
January 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27922741/how-do-dual-long-acting-bronchodilators-prevent-exacerbations-of-chronic-obstructive-pulmonary-disease
#17
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 β2-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
#18
REVIEW
M Zysman, F Chabot, P Devillier, B Housset, C Morelot-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...
December 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
#19
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...
2017: 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
#20
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
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