Clinical and economic impact of inhaled corticosteroid withdrawal in Spanish COPD patients treated with triple therapy

2021 ◽  
Author(s):  
Victoria Neches ◽  
Laura Amanda Vallejo-Aparicio ◽  
Afisi Ismaila ◽  
Antoni Sicras-Mainar ◽  
Aram Sicras-Navarro ◽  
...  
Keyword(s):  
Economic Impact ◽  
Triple Therapy ◽  
Inhaled Corticosteroid ◽  
Corticosteroid Withdrawal ◽  
Copd Patients

Economic impact of delayed multiple-inhaler triple therapy initiation in COPD patients

2020 ◽  
Author(s):  
Afisi Ismaila ◽  
Robert Wood ◽  
Glenn Anley ◽  
Yein Nam ◽  
Daniel Bluff ◽  
...  
Keyword(s):  
Economic Impact ◽  
Triple Therapy ◽  
Therapy Initiation ◽  
Copd Patients

scholarly journals PRS21 - ECONOMIC IMPACT OF DELAYING INITIATION WITH MULTIPLE INHALER MAINTENANCE TRIPLE THERAPY TREATMENT IN SPANISH COPD PATIENTS

2018 ◽  
Vol 21 ◽  
pp. S407
Author(s):  
A. Sicras-Mainar ◽  
A. Huerta ◽  
R. Navarro-Artieda ◽  
E. Monsó ◽  
S. Landis ◽  
...  
Keyword(s):  
Economic Impact ◽  
Triple Therapy ◽  
Copd Patients ◽  
Therapy Treatment

scholarly journals Pragmatic trial on inhaled corticosteroid withdrawal in patients with COPD in general practice

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Lisette van den Bemt ◽  
Lotte van den Nieuwenhof ◽  
Anne Rutjes ◽  
Victor van der Meer ◽  
Gerben Stege ◽  
...  
Keyword(s):  
General Practice ◽  
Inhaled Corticosteroids ◽  
Pragmatic Trial ◽  
Severe Exacerbation ◽  
Inhaled Corticosteroid ◽  
Corticosteroid Withdrawal ◽  
Copd Patients ◽  
Therapeutic Value ◽  
Exacerbation Risk ◽  
Bronchodilator Treatment

Abstract The therapeutic value of inhaled corticosteroids (ICSs) for COPD is limited. In published RCTs, ICS could be withdrawn in COPD patients without increasing exacerbation risk when bronchodilator treatment is optimized. Here we report on the feasibility and risks of ICS withdrawal in Dutch general practice for COPD patients without an indication for ICSs. In our pragmatic trial, general practitioners decided autonomously which of their COPD patients on ICS treatment could stop this, how this was done, and whether additional bronchodilator therapy was needed. We recruited 62 COPD patients (58 analysed) who were eligible for ICS withdrawal in 79 practices. In 32 patients (55.2%, 95% CI: 42.5–67.3%) ICS was withdrawn successfully, 19 (32.8%, 95% CI: 22.1–45.6%) restarted ICS treatment within six months, 12 patients (20.7%, 95% CI: 12.3–32.8%) had a moderate exacerbation, and one patient had a severe exacerbation. ICS withdrawal was successful in just over half of the patients with COPD without an indication for ICS.

scholarly journals Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy versus tiotropium monotherapy in patients with COPD

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Sandeep Bansal ◽  
Martin Anderson ◽  
Antonio Anzueto ◽  
Nicola Brown ◽  
Chris Compton ◽  
...  
Keyword(s):  
Health Status ◽  
Triple Therapy ◽  
Treatment Guidelines ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Fluticasone Furoate ◽  
Double Blind ◽  
Once Daily ◽  
Copd Patients ◽  
Severe Copd

AbstractChronic obstructive pulmonary disease (COPD) treatment guidelines do not currently include recommendations for escalation directly from monotherapy to triple therapy. This 12-week, double-blind, double-dummy study randomized 800 symptomatic moderate-to-very-severe COPD patients receiving tiotropium (TIO) for ≥3 months to once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 mcg via ELLIPTA (n = 400) or TIO 18 mcg via HandiHaler (n = 400) plus matched placebo. Study endpoints included change from baseline in trough forced expiratory volume in 1 s (FEV1) at Days 85 (primary), 28 and 84 (secondary), health status (St George’s Respiratory Questionnaire [SGRQ] and COPD Assessment Test [CAT]) and safety. FF/UMEC/VI significantly improved trough FEV1 at all timepoints (Day 85 treatment difference [95% CI] 95 mL [62–128]; P < 0.001), and significantly improved SGRQ and CAT versus TIO. Treatment safety profiles were similar. Once-daily single-inhaler FF/UMEC/VI significantly improved lung function and health status versus once-daily TIO in symptomatic moderate-to-very-severe COPD patients, with a similar safety profile.

scholarly journals A COMPARATIVE EVALUATION OF THE EFFICACY OF TRIPLE DRUG THERAPY WITH DUAL DRUG THERAPY IN COPD PATIENTS

2018 ◽  
Vol 10 (4) ◽  
pp. 105
Author(s):  
Pathan Amanulla Khan ◽  
A. Sujala ◽  
B.b. Sarah Nousheen ◽  
Ayesha Farhath Fatima ◽  
Hibba Tul Ala ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Combination Therapy ◽  
Triple Therapy ◽  
Drug Combination ◽  
Dual Therapy ◽  
Drug Combination Therapy ◽  
Copd Patients ◽  
Number Of Patients ◽  
Dual Drug

Objective: The present study was conducted with the objective of analyzing the efficacy of triple-drug combination therapy (formoterol, ciclesonide, tiotropium) by comparing it with double drug combination therapy (formoterol, budesonide).Methods: A prospective observational study was conducted. Sixty patients were enrolled, and divided into two groups of thirty each; one group was treated with the double-drug and the other with a triple drug combination. FEV1 and FVC pre-and post-treatment in either group were assessed spirometrically. Score ranges of 0-10, 11-20 and 21-30 were allotted to mild, moderate and severe categories and results were analyzed statistically.Results: Of the 60 patients recruited, 61-70 y olds constituted the majority (35%) of the population. Males (63.3%) were more in number compared to females (36.6%). Twenty-three of thirty-eight men smoked (60.5%); there were no female smokers. Common symptoms included cough (93.3%), dyspnoea (85%), fever (45%) and haemoptysis (15%). Hypertension accounted for 70% of patient comorbidities, followed by diabetes (60%) and cardiovascular diseases (40%). Three months after treatment with triple therapy, a significant increase in the differences of means of both FEV1 (14.27) and FVC (14.90) values was observed. Further analysis based on score ranges demonstrated that triple therapy administration markedly reduced the number of patients suffering from severe COPD.Conclusion: Our comparative analysis indicated that triple therapy was more effective in improving lung function, enhancing patients’ quality of life (evidenced from score ranges) thereby reducing mortality. While much is known about the greater effectiveness of triple over dual therapy, researchers to formulate the most effective triple therapy are in progress.

scholarly journals Costs, exacerbations and pneumonia after initiating combination tiotropium olodaterol versus triple therapy for chronic obstructive pulmonary disease

2019 ◽  
Vol 8 (15) ◽  
pp. 1299-1316 ◽  
Author(s):  
Swetha R Palli ◽  
Ami R Buikema ◽  
Mary DuCharme ◽  
Monica Frazer ◽  
Shuchita Kaila ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Triple Therapy ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Inverse Probability ◽  
Copd Patients ◽  
Baseline Characteristics ◽  
Long Acting ◽  
Medicare Database

Aim: To compare health plan-paid costs, exacerbations and pneumonia outcomes for patients with chronic obstructive pulmonary disease (COPD) initiating combination tiotropium olodaterol (TIO + OLO) versus triple therapy (TT: long-acting muscarinic antagonist + long-acting β2 agonists + inhaled corticosteroid). Patients & methods: COPD patients initiating TIO + OLO or TT between 1 January 2014 and 30 June 2016 were identified from a managed care Medicare database and balanced for baseline characteristics using inverse probability of treatment weighting before assessment of outcomes. Results: Annual COPD-related and all-cause costs were US$4118 (35%) and US$5384 (23%) lower for TIO + OLO versus TT (both p ≤ 0.001). TIO + OLO patients had nearly half the severe exacerbations (8.3 vs 15.5%; p = 0.014) and pneumonia was also less common (18.9 vs 30.9%; p < 0.001). Conclusion: TIO + OLO was associated with improved economic and COPD health outcomes versus TT.

Sign in / Sign up

Export Citation Format

Share Document