scholarly journals Inhaled corticosteroids with combination inhaled long-acting beta2 -agonists and long-acting muscarinic antagonists for chronic obstructive pulmonary disease

2016 ◽  
Author(s):  
Daniel J Tan ◽  
Clinton J White ◽  
Julia AE Walters ◽  
E Haydn Walters
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Muscarinic Antagonists ◽  
Obstructive Pulmonary Disease ◽  
Long Acting

Effect of chronic obstructive pulmonary disease treatment on cardiovascular outcome

ESC CardioMed ◽  
2018 ◽  
pp. 1050-1053
Author(s):  
Jennifer Quint
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Systemic Disease ◽  
Chronic Obstructive ◽  
Muscarinic Antagonists ◽  
Obstructive Pulmonary Disease ◽  
Beta Agonists ◽  
The People ◽  
Long Acting

The mainstay of pharmacological treatment of chronic obstructive pulmonary disease (COPD) treatment is inhalers, consisting of bronchodilators, both long-acting muscarinic antagonists and long-acting beta agonists, and inhaled corticosteroids. While the muscarinic antagonists and beta agonists act to open up the airways and have bronchodilating effects on smooth muscle thus decreasing breathlessness, inhaled corticosteroids dampen down the inflammatory process. COPD is considered a systemic disease and is associated with cardiovascular co-morbidities, but people with COPD who have cardiovascular disease (CVD) are often the very patients who are excluded from participating in randomized controlled trials of these medications thus making ascertainment of the true relationship between CVD and COPD treatments difficult. Trials suggest that long-acting muscarinic antagonists and long-acting beta agonists are safe when used in appropriate doses in people with COPD who do not have uncontrolled CVD, but in patients with underlying CVD or who use higher doses or more pharmacologically active medications the implications are less clear. Some people would argue that the data that currently exist from trials are not representative of real life and the long-term safety of COPD treatments is not known in the people in whom it matters most.

Current opportunities of inhaled corticosteroid therapy in patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 31 (1) ◽  
pp. 75-87
Author(s):  
I. V. Leshchenko ◽  
A. S. Meshcheryakova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Fixed Combination ◽  
Chronic Obstructive ◽  
Delivery Device ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Long Acting ◽  
Blood Eosinophils

Chronic obstructive pulmonary disease (COPD) is the leading cause of death in the structure of respiratory diseases. The problem of rational pharmacotherapy of COPD have attracted attention of the medical scientific society for many years. The understanding of the pathogenesis of the disease has deepened and approaches to the therapy have changed. Some COPD patients need regular fixed-combination therapy: long-acting bronchodilators (LABD) and inhaled corticosteroids (ICS) in order to prevent exacerbations and reduce the severity of symptoms of the disease. Blood eosinophils count is one of criteria for choosing regular therapy. The appearance of fixed triple combinations of ICS/LABD increased the effectiveness of COPD therapy, and a new delivery device for fixed combination of budesonide/formoterol makes it possible to use ICS successfully in the most severe patients.

scholarly journals Maintained therapeutic effect of revefenacin over 52 weeks in moderate to very severe Chronic Obstructive Pulmonary Disease (COPD)

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
James F. Donohue ◽  
Edward Kerwin ◽  
Sanjay Sethi ◽  
Brett Haumann ◽  
Srikanth Pendyala ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Outcomes ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Open Label ◽  
Double Blind ◽  
Obstructive Pulmonary Disease ◽  
Long Acting

Abstract Background Revefenacin is a long-acting muscarinic antagonist that was recently approved for the nebulized treatment of chronic obstructive pulmonary disease (COPD). Although shorter duration studies have documented the efficacy of revefenacin in COPD, longer-term efficacy has not been described. In a recent 52-week safety trial, revefenacin was well tolerated and had a favorable benefit-risk profile. Here we report exploratory efficacy and health outcomes in patients receiving revefenacin 175 μg or 88 μg daily during the 52-week trial. Methods In this randomized, parallel-group, 52-week trial (NCT02518139), 1055 participants with moderate to very severe COPD received revefenacin 175 μg or 88 μg in a double-blind manner, or open-label active control tiotropium. Results Over the 52-week treatment period, both doses of revefenacin, as well as tiotropium, elicited significant (all p < 0.0003) improvements from baseline in trough forced expiratory volume in 1 s (FEV1). The trough FEV1 profile (least squares mean change from baseline) for revefenacin 175 μg ranged from 52.3–124.3 mL and the trough FEV1 profile for tiotropium ranged from 79.7–112.8 mL. In subgroup comparisons, the effect of revefenacin on trough FEV1 was comparable in patients taking concomitant long-acting β-agonists, with or without inhaled corticosteroids, with patients who were not taking these medications. There were statistically significant (p < 0.05) improvements in all measured health status outcomes (evaluated using St. George’s Respiratory Questionnaire, COPD Assessment Test, Clinical COPD Questionnaire and Baseline and Transition Dyspnea Index) from 3 months onward, in all treatment arms. Conclusions Significant sustained improvements from baseline in trough FEV1 and respiratory health outcomes were demonstrated for 175-μg revefenacin over 52 weeks, further supporting its use as a once-daily bronchodilator for the nebulized treatment of patients with COPD. Trial registration NCT02518139; Registered 5 August 2015.

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