scholarly journals Effects of a single long-acting muscarinic antagonist agent and a long-acting muscarinic antagonist/long-acting β2-adrenoceptor agonist combination on lung function and symptoms in untreated COPD patients in Japan

2018 ◽  
Vol Volume 13 ◽  
pp. 3141-3147
Author(s):  
Hideyasu Yamada ◽  
Norihito Hida ◽  
Nobuyuki Hizawa
Keyword(s):  
Lung Function ◽  
Muscarinic Antagonist ◽  
Copd Patients ◽  
Adrenoceptor Agonist ◽  
Beta 2 ◽  
Long Acting

scholarly journals Single inhaler triple therapy in COPD – all that glitters is not gold

2021 ◽  
Vol 91 (2) ◽  
Author(s):  
Kartik Deshmukh ◽  
Arjun Khanna
Keyword(s):  
Lung Function ◽  
Triple Therapy ◽  
Inhaled Corticosteroid ◽  
Muscarinic Antagonist ◽  
Exacerbation Frequency ◽  
Long Acting ◽  
Beta2 Agonist

Dear Editor, The recent studies on combination triple therapy of inhaled corticosteroid, long acting beta2 agonist and long-acting muscarinic antagonist (ICS-LABA-LAMA) in COPD have consistently demonstrated an improvement in exacerbation frequency and/or improvement of lung function...

scholarly journals Efficacy and safety of long-acting β-agonist/long-acting muscarinic antagonist combinations in COPD: a network meta-analysis

Thorax ◽  
2015 ◽  
Vol 71 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Yuji Oba ◽  
Siva T Sarva ◽  
Sofia Dias
Keyword(s):  
Lung Function ◽  
Meta Analysis ◽  
Credible Interval ◽  
Severe Exacerbation ◽  
Efficacy And Safety ◽  
Muscarinic Antagonist ◽  
Safety Outcomes ◽  
Randomised Control Trials ◽  
St George's Respiratory Questionnaire ◽  
Long Acting

BackgroundThe place of long-acting β agonist/long-acting muscarinic antagonist (LABA/LAMA) combinations in stable patients with COPD is not well defined. The purpose of this study was to systematically review the efficacy and safety of LABA/LAMA combinations.MethodsSeveral databases and manufacturers’ websites were searched for relevant clinical trials. Randomised control trials, at least 12 weeks duration, comparing a LABA/LAMA combination with placebo and/or monotherapy were included. The data were pooled using a network as well as a traditional direct comparison meta-analysis.ResultsTwenty-three trials with a total of 27 172 patients were included in the analysis. LABA/LAMA combinations were associated with a greater improvement in lung function, St. George's Respiratory Questionnaire (SGRQ) score, and Transitional Dyspnoea Index (TDI) than monotherapies. LABA/LAMA combinations were associated with a significantly greater proportion of SGRQ and TDI responders than monotherapies (OR 1.23 (95% credible interval (CrI) 1.06–1.39), OR 1.34 (95% CrI 1.19–1.50) versus LABAs and OR 1.24 (95% CrI 1.11–1.36), OR 1.31 (95% CrI 1.18–1.46) versus LAMAs, respectively) and fewer moderate-to-severe exacerbations compared with LABAs (HR 0.82 (95% CrI 0.73–0.93)), but not when compared with LAMAs (HR 0.92 (95% CrI 0.84–1.00)). There were no statistically significant differences associated with LABA/LAMA combinations compared with monotherapies in safety outcomes as well as in severe exacerbations.ConclusionsThe combination therapy was the most effective strategy in improving lung function, quality of life, symptom scores and moderate-to-severe exacerbation rates, and had similar effects on safety outcomes and severe exacerbations as compared with monotherapies.

scholarly journals Pharmacological and clinical profile of indacaterol maleate (Onbrez^|^reg;), an inhaled long-acting ^|^beta;2-adrenoceptor agonist

2012 ◽  
Vol 140 (1) ◽  
pp. 36-43
Author(s):  
Kazuhiko Suzuki ◽  
Masahiko Uchiyama ◽  
Soichiro Matsushima ◽  
Mika Yoshiki ◽  
Tetsuji Kitawaki
Keyword(s):  
Clinical Profile ◽  
Adrenoceptor Agonist ◽  
Beta 2 ◽  
Long Acting

scholarly journals The TRIFLOW study: a randomised, cross-over study evaluating the effects of extrafine beclometasone/formoterol/glycopyrronium on gas trapping in COPD

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
James Dean ◽  
Catalina Panainte ◽  
Naimat Khan ◽  
Dave Singh
Keyword(s):  
Lung Function ◽  
Triple Therapy ◽  
Small Airway ◽  
Mean Difference ◽  
Open Label ◽  
Post Dose ◽  
Airway Function ◽  
Copd Patients ◽  
Gas Trapping ◽  
Long Acting

Abstract Background The effects of triple therapy on gas trapping in COPD are not fully understood. We evaluated the effects of the long acting bronchodilator components of the extrafine single inhaler triple therapy beclometasone dipropionate/formoterol/glycopyrronium (BDP/F/G) pMDI on gas trapping. Methods This open-label, randomised, single centre, 2-way cross-over study recruited 23 COPD patients taking inhaled corticosteroid combination treatments and with residual volume (RV) > 120% predicted at screening. Inhaled BDP was taken during run-in and washout periods. Baseline lung function (spirometry, lung volumes, oscillometry) was measured over 12 h prior to randomisation to BDP/F/G or BDP/F for 5 days followed by washout and crossover. Lung function was measured prior to dosing on day 1 and for 12 h post-dose on day 5. Results Co-primary endpoint analysis: BDP/F/G had a greater effect than BDP/F on FEV1 area under the curve over 12 h (AUC0–12) (mean difference 104 mls, p = 0.0071) and RV AUC0–12 (mean difference − 163 mls, p = 0.0028). Oscillometry measurements showed a greater effect of BDP/F/G on the difference between resistance at 5 and 20 Hz (R5–R20) AUC0–12, which measures small airway resistance (mean difference − 0.045 kPa/L/s, p = 0.0002). Comparison of BDP/F with the baseline measurements (BDP alone) showed that F increased FEV1 AUC0–12 (mean difference 227 mls) and improved RV AUC0–12 (mean difference − 558 mls) and R5–R20 AUC0–12 (mean difference − 0.117 kPa/L/s), all p < 0.0001. Conclusions In COPD patients with hyperinflation, the G and F components of extrafine BDP/F/G improved FEV1, RV and small airway function. These long acting bronchodilators target small airway function, thereby improving gas trapping and airflow. Trial registration The study was retrospectively registered at ClinicalTrials.gov on 15th February 2019 (No.: NCT03842904, https://clinicaltrials.gov/ct2/show/NCT03842904).

scholarly journals Bronchodilatory effects of NVA237, a once daily long-acting muscarinic antagonist, in COPD patients

2011 ◽  
Vol 105 (3) ◽  
pp. 337-342 ◽  
Author(s):  
Charles Fogarty ◽  
Helen Hattersley ◽  
Lilla Di Scala ◽  
Anton Drollmann
Keyword(s):  
Once Daily ◽  
Muscarinic Antagonist ◽  
Copd Patients ◽  
Long Acting

scholarly journals Comparison of Effectiveness Using Different Dual Bronchodilator Agents in Chronic Obstructive Pulmonary Disease Treatment

2021 ◽  
Vol 10 (12) ◽  
pp. 2649
Author(s):  
Shih-Lung Cheng
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Combination Therapy ◽  
Fixed Dose ◽  
Chronic Obstructive ◽  
Bronchodilator Agents ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Dose Combination ◽  
Long Acting

The effectiveness and safety of fixed dual long-acting bronchodilators for chronic obstructive pulmonary disease (COPD) patients have 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 effectiveness of three once-daily dual bronchodilator agents in patients with COPD. Patients 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 (tiotropium 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. The enrolled patients’ number was 177 in IND/GLY, 176 in UME/VIL and 183 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 UME/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 UME/VIL (3.9) (p = 0.03). Acute exacerbation was also reduced in patients using TIO/OLO (4.9%) compared with those using IND/GLY (10.2%) and UME/VIL (11.9%) (p = 0.01). Significant improvement in pulmonary function, symptoms were demonstrated after 12 months of LABA/LAMA fixed-dose combination therapy with three 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.

scholarly journals A randomized controlled trial of long-acting muscarinic antagonist and long-acting β2 agonist fixed-dose combinations in patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masato Muraki ◽  
Yuki Kunita ◽  
Ken Shirahase ◽  
Ryo Yamazaki ◽  
Soichiro Hanada ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Questionnaire Survey ◽  
Fixed Dose ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Muscarinic Antagonist ◽  
Copd Patients ◽  
Long Acting ◽  
Β2 Agonist

Abstract Background In chronic obstructive pulmonary disease (COPD) patients, combination treatment with long-acting muscarinic antagonist (LAMA) and long-acting β2 agonist (LABA) increases forced expiratory volume in one second and reduces symptoms compared to monotherapy. In Japan, three different once-daily fixed-dose combinations (FDCs) have been prescribed since 2015, although a direct comparison of these FDCs has never been performed. The objective of the present study was to compare the effectiveness, preference, and safety of three LAMA/LABA FDCs—glycopyrronium/indacaterol (Gly/Ind), umeclidinium/vilanterol (Ume/Vil), and tiotropium/olodaterol (Tio/Olo)—in patients with COPD. Methods We enrolled 75 COPD outpatients (male:female ratio, 69:6; 77.4 ± 6.9 years). A prospective, randomized, crossover study was conducted on three groups using three FDCs: Gly/Ind; Ume/Vil; and Tio/Olo. Each medication was administered for 4 weeks before crossover (total 12 weeks). After each FDC administration, a respiratory function test and questionnaire survey were conducted. A comparative questionnaire survey of all three LAMA/LABA FDCs was conducted after 12 weeks (following administration of final FDC). Results No significant differences in COPD Assessment Test or modified Medical Research Council dyspnea questionnaire were reported in the surveys completed after each FDC administration; no significant differences in spirometric items were observed. In the final comparative questionnaire survey, patients reported better actual feeling of being able to inhale following Gly/Ind administration compared with Tio/Olo, although no significant differences in adverse events or other evaluations were reported. Conclusions The three LAMA/LABA FDCs administered to COPD patients show similar effects and safety, although some minor individual preference was reported. Trial registration This study retrospectively registered with the University Hospital Medical Information Network Clinical Trials Registry (number UMIN000041342, registered on August 6, 2020).

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