Comparison of a Combination of Tiotropium Plus Formoterol to Salmeterol Plus Fluticasone in Moderate COPD

Rabe, Klaus F.; Timmer, Wolfgang; Sagkriotis, Alexandros; Viel, K.

doi:10.1378/chest.07-2138

Cited by 114 publications

(54 citation statements)

References 30 publications

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“…Although evidence from subgroup analyses of large studies of LABA-ICS combinations has shown that they are effective in moderate COPD, the benefit attributable to the ICS component is not as large as it is in asthma [37,38]. As previous reported by Rabe et al [39] improvements in spirometric value for FEV 1 with tiotropium and formoterol were significantly greater compared with salmeterol plus fluticasone. Recently, Vogelmeier et al [40] found once daily QVA149 (combination of glycopyronium and indacaterol) provides a significant higher increasing in FEV 1 than twice daily Advair ® .…”

Section: Discussionmentioning

confidence: 73%

Comparison of airway dimensions with once daily tiotropium plus indacaterol versus twice daily Advair® in chronic obstructive pulmonary disease

Hoshino

Ohtawa

Akitsu

2015

Pulmonary Pharmacology & Therapeutics

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Section: Discussionmentioning

confidence: 73%

Comparison of airway dimensions with once daily tiotropium plus indacaterol versus twice daily Advair® in chronic obstructive pulmonary disease

Hoshino

Ohtawa

Akitsu

2015

Pulmonary Pharmacology & Therapeutics

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“…an increase in the dose of the bronchodilator according to its pharmacologic characteristics [26][27][28][29]; the addition of a second long-acting bronchodilator with a different mechanism of action [34][35][36][37][38][39][40][41][42][43][44]; the addition of inhaled corticosteroid (ICS), in patients with frequent exacerbations [8,9,11,[39][40][41].…”

Section: Recommendationsmentioning

confidence: 99%

The clinical and integrated management of COPD. An official document of AIMAR (Interdisciplinary Association for Research in Lung Disease), AIPO (Italian Association of Hospital Pulmonologists), SIMER (Italian Society of Respiratory Medicine), SIMG (Italian Society of General Medicine)

Bettoncelli

Blasi

Brusasco

et al. 2014

Multidisciplinary Respiratory Medicine

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COPD is a chronic pathological condition of the respiratory system characterized by persistent and partially reversible airflow obstruction, to which variably contribute remodeling of bronchi (chronic bronchitis), bronchioles (small airway disease) and lung parenchyma (pulmonary emphysema). COPD can cause important systemic effects and be associated with complications and comorbidities. The diagnosis of COPD is based on the presence of respiratory symptoms and/or a history of exposure to risk factors, and the demonstration of airflow obstruction by spirometry. GARD of WHO has defined COPD "a preventable and treatable disease". The integration among general practitioner, chest physician as well as other specialists, whenever required, assures the best management of the COPD person, when specific targets to be achieved are well defined in a diagnostic and therapeutic route, previously designed and shared with appropriateness. The first-line pharmacologic treatment of COPD is represented by inhaled long-acting bronchodilators. In symptomatic patients, with pre-bronchodilator FEV1 < 60% predicted and ≥ 2 exacerbations/year, ICS may be added to LABA. The use of fixed-dose, single-inhaler combination may improve the adherence to treatment. Long term oxygen therapy (LTOT) is indicated in stable patients, at rest while receiving the best possible treatment, and exhibiting a PaO 2 ≤ 55 mmHg (SO 2 < 88%) or PaO 2 values between 56 and 59 mmHg (SO 2 < 89%) associated with pulmonary arterial hypertension, cor pulmonale, or edema of the lower limbs or hematocrit > 55%. Respiratory rehabilitation is addressed to patients with chronic respiratory disease in all stages of severity who report symptoms and limitation of their daily activity. It must be integrated in an individual patient tailored treatment as it improves dyspnea, exercise performance, and quality of life. Acute exacerbation of COPD is a sudden worsening of usual symptoms in a person with COPD, over and beyond normal daily variability that requires treatment modification. The pharmacologic therapy can be applied at home and includes the administration of drugs used during the stable phase by increasing the dose or modifying the route, and adding, whenever required, drugs as antibiotics or systemic corticosteroids. In case of patients who because of COPD severity and/or of exacerbations do not respond promptly to (Continued on next page)

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“…LABA and long-acting antimuscarinic agents undergoing development Several recent clinical trials have shown that concomitant therapy with a LABA and tiotropium provides significant and clinically relevant improvements in bronchodilation and COPD symptoms over each individual bronchodilator [80][81][82][83][84][85] or a LABA/ICS combination [86]. Moreover, a combination of a LABA and a LAMA is more effective than treatment with either bronchodilator alone in reducing the rate of exacerbations [84].…”

Section: Novel Combinationsmentioning

confidence: 99%

Emerging inhaled bronchodilators: an update

Cazzola¹,

Matera²

2009

Eur Respir J

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Bronchodilators remain central to the symptomatic management of chronic obstructive pulmonary disease and asthma, and, for this reason and also because the patent protection of many bronchodilators has expired, several companies have reinitiated research into the field.The only limits set for the development of a long-lasting bronchodilator with a new product profile are medical needs and marketing opportunities. The incorporation of once-daily dose administration is an important strategy for improving adherence and is a regimen preferred by most patients.A variety of b 2 -agonists and antimuscarinic agents with longer half-lives and inhalers containing a combination of several classes of long-acting bronchodilator are currently under development.The present article reviews all of the most important compounds under development, describing what has been done and discussing their genuine advantage.

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Comparison of a Combination of Tiotropium Plus Formoterol to Salmeterol Plus Fluticasone in Moderate COPD

Cited by 114 publications

References 30 publications

Comparison of airway dimensions with once daily tiotropium plus indacaterol versus twice daily Advair® in chronic obstructive pulmonary disease

Comparison of airway dimensions with once daily tiotropium plus indacaterol versus twice daily Advair® in chronic obstructive pulmonary disease

The clinical and integrated management of COPD. An official document of AIMAR (Interdisciplinary Association for Research in Lung Disease), AIPO (Italian Association of Hospital Pulmonologists), SIMER (Italian Society of Respiratory Medicine), SIMG (Italian Society of General Medicine)

Emerging inhaled bronchodilators: an update

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