scholarly journals A retrospective study to assess clinical characteristics and time to initiation of open-triple therapy among patients with chronic obstructive pulmonary disease, newly established on long-acting mono- or combination therapy

2017 ◽  
Vol Volume 12 ◽  
pp. 1825-1836 ◽  
Author(s):  
Douglas Mapel ◽  
Francois Laliberté ◽  
Melissa Roberts ◽  
Susan Sama ◽  
Devi Sundaresan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Retrospective Study ◽  
Combination Therapy ◽  
Triple Therapy ◽  
Pulmonary Disease ◽  
Clinical Characteristics ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Time To Initiation ◽  
Long Acting

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.

scholarly journals Comparison of Effectiveness Using Different Dual Broncho- dilator Agents in Chronic Obstructive Pulmonary Disease Treatment

2020 ◽  
Author(s):  
Shih-Lung Cheng
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Combination Therapy ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Fixed Dose ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Dose Combination ◽  
Long Acting

Abstract BackgroundThe efficacy and safety of fixed dual long-acting bronchodilators for chronic obstruction pulmonary disease (COPD) patients has been well established; however, there is a paucity of clinical effectiveness comparison in patients with COPD treatment. The aim of the current study was to compare the efficacy of three once daily dual bronchodilator agents in patients with COPD.MethodsPatients with diagnosed COPD and treated with a long-acting beta agonist (LABA) + long-acting muscarinic antagonist (LAMA) fixed-dose combination therapy (UME/VIL [umeclidinium and vilanterol inhalation powder], IND/GLY [indacaterol and glycopyrronium], and TIO/OLO [tiotoprium and olodaterol]) were enrolled in this retrospective study over a period of 12 months. Effectiveness assessments were evaluated using a COPD assessment test (CAT) and lung function parameters. Besides, times for acute exacerbation were also assessed.ResultsThe enrolled patients’ number was 77 in IND/GLY, 76 in UME/VIL and 83 in TIO/OLO. Lung function measurements with FEV1 had significantly improved for patients using TIO/OLO (98.7 ml) compared to those of IND/GLY (65.2 ml) and UMEC/VIL (64.4 ml) (p<0.001). CAT scores were also significantly decreased in patients treated with TIO/OLO (CAT down 5.6) than those with IND/GLY (3.8) and UMEC/VIL (3.9) (p=0.03). Acute exacerbation was also reduced in patients using TIO/OLO (4.8%) compared with those using IND/GLY (10.4%) and UMEC/VIL (10.5%) (p=0.01).ConclusionSignificant improvement in pulmonary function, symptoms were demonstrated after 12 months of LABA+LAMA fixed-dose combination therapy with 3 different treatment options. TIO/OLO demonstrated higher therapeutic effects compared with UME/VIL or IND/GLY. Determining clinical relevance will require a well-designed randomized controlled trial.Key Words: Chronic obstructive pulmonary disease (COPD), dual bronchodilator, LABA/LAMA

scholarly journals The Use of Triple Therapy in Chronic Obstructive Pulmonary Disease and Outcomes of the IMPACT Trial

2018 ◽  
Vol 4 (1) ◽  
pp. 17 ◽  
Author(s):  
Mario Cazzola ◽  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Triple Therapy ◽  
Pulmonary Disease ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Exacerbation Rate ◽  
Obstructive Pulmonary Disease ◽  
Expert Interview ◽  
Long Acting ◽  
The Impact

Triple inhaled therapy for chronic obstructive pulmonary disease (COPD) comprises the combination of an inhaled corticosteroid (ICS), a long-acting β2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA). The use of triple therapy is recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for patients who experience recurrent exacerbations despite treatment with either a dual bronchodilator or LABA/ICS combination.1 Evidence exists for the superior efficacy of triple therapy compared with LABA/ICS and LAMA monotherapy with regards to improved lung function, health status, and exacerbation rate. However, the benefits of triple therapy compared with dual bronchodilation (LABA/LAMA) are uncertain.2 The IMPACT study compared triple therapy and dual inhaler therapy comprising LABA/LAMA in patients with COPD.3 In an expert interview, Dr Cazzola discusses this study and its implications for clinical practice.

Role of Long-Acting Muscarinic Antagonist/Long-Acting β2-Agonist Therapy in Chronic Obstructive Pulmonary Disease

2017 ◽  
Vol 51 (8) ◽  
pp. 696-705 ◽  
Author(s):  
Sarah E. Petite
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Combination Therapy ◽  
Maintenance Therapy ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Muscarinic Antagonist ◽  
Randomized Controlled ◽  
Long Acting ◽  
Copd Maintenance

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. References from extracted sources were further searched for any relevant, missed data sources. Study Selection and Data Extraction: All English-language randomized-controlled trials comparing LAMA/LABA and ICS/LABA combination inhaler therapy were evaluated. Data Synthesis: A total of 10 randomized controlled trials have reviewed the use of LAMA/LABA compared with ICS/LABA therapy for COPD maintenance therapy. Results of clinical trials that evaluated LAMA/LABA and ICS/LABA maintenance therapy demonstrated superior improvements in pulmonary function tests via spirometry and improved clinical outcomes with LAMA/LABA therapy, specifically reduction in COPD exacerbation rates. The safety of LAMA/LABA combination therapy also is favorable compared with ICS/LABA combination therapy because of the increased infection risk with ICS therapy. Conclusions: COPD is a disease state with significant morbidity and mortality in the United States and is the third leading cause of death. Long-acting inhalers are recommended for the majority of COPD severities, and combination therapy is typically utilized. LAMA/LABA combination therapy has demonstrated superior improvements in pulmonary function and reduction in COPD exacerbation rates compared with ICS/LABA. LAMA/LABA combination therapy will have a larger future role in COPD maintenance management.

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