scholarly journals Fixed dose long-acting bronchodilator combinations in chronic obstructive pulmonary disease: safety, effectiveness and cardiovascular system

2018 ◽  
pp. 18-26
Author(s):  
I. V. Leshchenko

At present time, long-acting bronchodilators are the main class of drugs for basis therapy of chronic obstructive pulmonary disease (COPD). COPD is characterized not only by a decrease in pulmonary function parameters, but also by a decline in cardiac contractility. The article presents the results of studies of four approved fixed long-acting anticholinergic drugs/long-acting beta2-agonists in the Russian Federation, according their effect on the cardiovascular system. The safety of LAMA/ LABA was proved in terms of relation to the cardiovascular system, additionally the positive effect on the pumping function of the heart was shown in patients with COPD, which confirms the value of dual bronchodilators for COPD treatment.

2021 ◽  
Vol 31 (4) ◽  
pp. 511-516
Author(s):  
A. G. Romanovskikh ◽  
A. I. Sinopal’nikov ◽  
Yu. G. Belotserkovskaya ◽  
I. P. Smirnov

One of the important features of the chronic obstructive pulmonary disease is the presence of concomitant chronic diseases in most of patients. And cardiovascular conditions occupy a special place among these comorbidities. The most common diseases associated with COPD are hypertension, coronary heart disease, and heart failure. They aggravate the clinical manifestations of the disease and have negative effect on the prognosis. In addition, concomitant cardiovascular conditions determine the need for a thorough safety assessment of the ongoing pharmacotherapy for COPD. Core of the treatment is bronchodilators. The priority pharmacological strategy is the use of fixed-dose combinations of long-acting β2 -agonists and long-acting anticholinergic medications.The purpose of this review was to evaluate the safety profile of tiotropium/olodaterol in COPD.Methods. This article presents the data obtained from studies of the safety of the use of tiotropium/olodaterol in patients with COPD and concomitant cardiovascular conditions.Results. The studies showed no increase in the risk of cardiovascular events when using this combination in patients of this category.Conclusion. А good safety profile of tiotropium/olodaterol was confirmed in patients with COPD and concomitant cardiovascular conditions.


2020 ◽  
Author(s):  
Shih-Lung Cheng

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


2018 ◽  
pp. 28-37
Author(s):  
A. I. Sinopalnikov ◽  
A. G. Romanovskikh ◽  
Yu. G. Belotserkovskaya

The use of bronchodilators (DB) remains up to the present day the leading therapeutic strategy for the treatment of chronic obstructive pulmonary disease (COPD), in which case administration of fixed-dose combinations of long-acting bronchodilators seem the most promising. At the same time, the issues of anti-inflammatory therapy of COPD are also actively discussed, first of which is feasibility for the wide use of fixed-dose combinations of inhaled glucocorticosteroids (IHGC) with long-acting β2-agonists (LABA). Recent years are characterized by the launch of a significant number of new BDs, anti-inflammatory drugs and their combinations to the pharmaceutical market. The article considers the role and place of new drugs in the treatment of COPD having a stable course.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masato Muraki ◽  
Yuki Kunita ◽  
Ken Shirahase ◽  
Ryo Yamazaki ◽  
Soichiro Hanada ◽  
...  

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).


2018 ◽  
Vol 96 (3) ◽  
pp. 257-261
Author(s):  
Anna G. Romanovskikh ◽  
Yu. G. Belotserkovskaya ◽  
I. P. Smirnov

Chronic obstructive pulmonary disease (COPD) is an urgent problem of modern healthcare. One of the most frequent approaches to the therapy of the COPD remains the appointment of inhaled corticosteroids (ICSs) and long-acting β2-agonists (LABAs) in fixed-dose combinations. At the same time, the role and place of fixed-dose combinations (ICS/LABA) in COPD therapy is currently being actively discussed. The presented article describes the efficacy and safety of fixed-dose combinations (ICS/LABA) in COPD patients, modern approaches to the appointment of ICS/LABA.


2020 ◽  
Vol 7 (10) ◽  
pp. 1519
Author(s):  
Bharat Gopal ◽  
K. S. Satish ◽  
Samir Garde ◽  
Niranjan Kumar Sit ◽  
Dipali Kamdar ◽  
...  

Background: Long-term therapy for chronic obstructive pulmonary disease (COPD) is progressing fast. Dual bronchodilation with long-acting muscarinic antagonist (LAMA) and long-acting β2-agonist (LABA) fixed dose combinations (FDC) have been available over the past few years. To evaluate the real-world tolerability and effectiveness of formoterol plus glycopyrronium FDC inhaler, a post-marketing surveillance study was conducted in Indian population.Methods: This was an open-label, observational registry in which COPD patients, who were prescribed forglyn (a brand of FDC of glycopyrronium 25 mcg and formoterol fumarate dihydrate 6 mcg dry powder inhalation). The effectiveness, safety and tolerability of this LAMA/LABA combination were evaluated for 4, 8 and 12 weeks. The safety and tolerability was assessed based on the incidence of adverse events (AEs). Effectiveness was evaluated based on change in total symptom score from baseline to end of 12 weeks. The forced expiratory volume in 1 second (FEV1) was performed at baseline and end of 12 weeks.Results: Total COPD patients enrolled were 605, of which 78.5% were males and 21.5% were females. Patients showing improvement of symptoms at week 4 were 587 (97.02%).Overall, at the end of 8 week and 12 week 98.34 % and 99.49% patients showed improvement in the total symptoms respectively. About 0.49% did not show any improvement. AEs were reported in 64 (10.64%) patients with no serious AEs. Mean FEV1 of 476 patients before treatment was 1.53±0.68 L at baseline which changed to 1.85±4.74 L at the end of 12 weeks, with was statistically significant (p<0.05).Conclusions: In real-life clinical practice in India, formoterol and glycopyrronium FDC dry powder inhaler was well tolerated in COPD patients, and can be regarded as an effective option for maintenance treatment.


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