scholarly journals Clinical outcome of adding long-acting β-agonists to inhaled corticosteroids

2001 ◽  
Vol 95 ◽  
pp. S12-S16 ◽  
Author(s):  
P.J. Barnes
Keyword(s):  
Clinical Outcome ◽  
Inhaled Corticosteroids ◽  
Long Acting

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.

Utilization Patterns and Trends in The Use of Medications for Asthma Control in a Cohort of Colombian Patients, 2017-2019. v1

2021 ◽  
Author(s):  
Jorge Machado Alba
Keyword(s):  
Retrospective Study ◽  
General Practitioner ◽  
Health System ◽  
Triple Therapy ◽  
Inhaled Corticosteroids ◽  
Prescription Patterns ◽  
Utilization Patterns ◽  
Control Therapy ◽  
Long Acting

Objective:To determine the trend in the use of medications used to treat asthma in a group of patients affiliated to the Colombian health system. Methods:A retrospective study on prescription patterns of medications used to treat asthma in patients over 5 years of age between 2017 and 2019. Sociodemographic variables, medications used and combinations, persistence of use and prescribing physician were considered. Results:10,706 people with a diagnosis of asthma were identified, with predominance in female sex (56.8 %), median age 32.2 ± 26.1 years. At the start of follow-up, 53.2% of patients aged 5-11 years were receiving monotherapy, mean 1.5 ± 0.6 drugs/patient, especially inhaled corticosteroids (ICS; 55.9%) and short-acting β-agonists (SABA; 55.6%). Moreover, in patients older than 12 years, 53.5% were treated in monotherapy, mean 1.6 ± 0.7 drugs/patient, of which 45.9% were on SABA, and 37.1 % on ICS.Between 63.0% and 83.6% of patients were treated by a general practitioner. The proportion of patients on the ICS/ long-acting β-agonists (LABA) combination grew at 24 months follow-up by 411% and 177%, respectively. 12.5% of patients (495) received triple therapy (ICS/LABA+LAMA [long-acting anticholinergics]), particularly with fluticasone/salmeterol+tiotropium. Conclusions:Patients with a diagnosis of asthma older than 5 years in Colombia are mainly receiving control therapy with ICS, alone or combined with SAMA and, to a lesser extent, with LABA.

Patterns of use and trends in the use of medications for the control of COPD in a cohort of Colombian patients, 2017-2019 v1

2021 ◽  
Author(s):  
Jorge Machado Alba
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Population Database ◽  
Obstructive Pulmonary Disease ◽  
Prescription Patterns ◽  
Short Acting ◽  
Patterns Of Use ◽  
Long Acting

Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 174 million people worldwide.The objective was to determine the trends of the use of medications for COPD in a group of Colombian patients. Methods: This was a retrospective study on prescription patterns of bronchodilators and other medications used in COPD from a population database with follow-up at 12 and 24 months. Patients older than 18 years of age of any sex who had COPD between 2017 and 2019 were included. Sociodemographic variables, medications, treatment schedules for COPD, comorbidities, comedications, and the specialty of the prescriber were considered. Results: A total of 9,476 people with a diagnosis of COPD were evaluated. They had a mean age of 75.9 ± 10.7 years, 50.1% were men, and 86.8% were prescribed by a general practitioner. At the beginning of the follow-up, on average, they received 1.6 medications/patient, mainly short-acting antimuscarinics (3784; 39.9%), followed by short-acting β-agonists (2997, 31.6%) and inhaled corticosteroids (ICS) (2239, 23.6%), but 5083 (53.6%) patients received a long-acting bronchodilator. At the beginning of the follow-up, 645 (6.8%) patients were put on triple therapy with antimuscarinics, β-agonists, and ICS, and at 12 months, this rose to 1388 (20.6%). A total of 57.9% had comorbidities, most often hypertension (44.4%). Conclusions: This group of patients with COPD treated in Colombia frequently received short-acting bronchodilators and ICS, but a growing proportion are undergoing controlled therapy with long-acting bronchodilators, a situation that can improve the indicators of morbidity, exacerbations, and hospitalization.

scholarly journals Health-Related Effects of Home Nebulization With Glycopyrronium on Difficult-to-Treat Asthma: Post-Hoc Analyses of an Observational Study (Preprint)

2020 ◽  
Author(s):  
Deepak Talwar ◽  
Salil Bendre
Keyword(s):  
Adverse Events ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Moderate Intensity ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
Mean Values ◽  
Control Score ◽  
Long Acting ◽  
Post Hoc

BACKGROUND Bronchial asthma remains a clinical enigma with poorly controlled symptoms or exacerbations despite regular use of inhaled corticosteroids. Home nebulization offers a simplified solution for the delivery of rescue and maintenance bronchodilators, which is especially true for patients with frequent exacerbations during management of uncontrolled or difficult-to-treat asthma. OBJECTIVE We aimed to assess the clinical impact and outcomes associated with home nebulization—delivered long-acting bronchodilators for uncontrolled or difficult-to-treat asthma. METHODS This observational, concurrent study was conducted with 60 patients at 2 centers during November 2018. Statistical analyses for prebronchodilator forced expiratory volume in one second (FEV1) and Global Initiative for Asthma (GINA) asthma control score in patients on long-acting bronchodilators and corticosteroids were conducted, with two-tailed <i>P</i> values &lt;.05 considered statistically significant. RESULTS Per protocol analyses (53/60) for consecutive cases receiving home nebulization with long-acting bronchodilators and corticosteroids were conducted. The baseline demographics included a male-to-female ratio of 30:23 and mean values of the following: age, 60.3 years (SD 11.8 years); weight, 64 kg (SD 16.8 kg); FEV1, 43% (SD 16%); GINA asthma control score, 3.0 points (SD 0.8 points); serum eosinophil level, 4% (SD 3%); fractional exhaled nitric oxide (FeNO), 12.1 ppb (SD 6 ppb). Of the patients, 100% (53/53) had uncontrolled symptoms, 69.8% (37/53) had prior exacerbations, 100% (53/53) used formoterol/budesonide, and 75.5% (40/53) used glycopyrronium. The per protocol group (n=53) had significantly improved mean prebronchodilator FEV1 (23.7%, SD 29.8%; 0.46 L, SD 0.58 L; <i>P</i>&lt;.001) and GINA asthma control score (2.1 points, SD 0.8 points, <i>P</i>&lt;.001). At baseline, patients (n=40) receiving glycopyrronium/formoterol/budesonide (25/20/500 mcg) nebulization admixture had the following mean values: prebronchodilator FEV1, 38% (SD 15%); GINA asthma control score, 3.0 points (SD 0.8 points); reversibility, 12% (SD 6%); peripheral eosinophil level, 4% (SD 3%); FeNO, 12 ppb (SD 5.7 ppb). In the post hoc analyses, these patients had significantly improved mean prebronchodilator FEV1 of 27.7% (SD 26.2%; 0.54 L, SD 0.51 L; <i>P</i>&lt;.001) at 8 weeks compared with baseline. At baseline, patients (n=13) receiving formoterol/budesonide (20/500 mcg) nebulization had the following mean values: FEV1, 55% (SD 12%); GINA asthma control score, 3.0 points (SD 1.2 points); reversibility, 14% (SD 7%); serum eosinophil level, 4% (SD 3%); FeNO, 13.3 ppb (SD 6.8 ppb). In the post hoc analyses, these patients showed a significant improvement in prebronchodilator FEV1 of 11.2% (SD 13.1%; 0.22 L, SD 0.25 L; <i>P</i>&lt;.001) from baseline. Breathlessness of mild to moderate intensity was reported by 10 cases (10/53, 18.9%), with no other treatment-emergent adverse events or serious adverse events. CONCLUSIONS Home nebulization remains a viable option for symptomatic difficult-to-treat asthma cases with frequent use of rescue medications. Glycopyrronium as add-on therapy offers a synergistic response in patients on corticosteroids with difficult-to-treat asthma. CLINICALTRIAL Clinical Trial Registry of India CTRI/2018/11/016319; https://tinyurl.com/y78cctm3

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