Recent advances in COPD disease management with fixed-dose long-acting combination therapies

Abstract

Combinations of two long-acting bronchodilators and long-acting bronchodilators with inhaled corticosteroids (ICS) are recommended therapies in the management of chronic obstructive pulmonary disease (COPD). Three fixed-dose combination products have recently been approved for the treatment of COPD (the long-acting β2-agonist plus long-acting muscarinic antagonist [LABA/LAMA] combinations glycopyrronium/indacaterol [QVA149] and umeclidinium/vilanterol, and the LABA/ICS fluticasone furoate/vilanterol), with others currently in late-stage development. LABA/LAMA and LABA/ICS combination therapies demonstrate positive effects on both lung function and patient-reported outcomes, with significant improvements observed with LABA/LAMA combinations compared with placebo, each component alone and other comparators in current use. No new safety concerns have been observed with combinations of long-acting bronchodilators. Combinations of two long-acting bronchodilators represent a new and convenient treatment option in COPD. This review summarizes published efficacy and safety data from clinical trials of both LABA/LAMA and novel LABA/ICS combinations in patients with COPD.

Perspectives of pharmacological therapy of chronic obstructive pulmonary disease: opportunities of dual bronchodilation and a role of inhaled steroids. Expert Council Consensus

“…Поло жительные результаты данных исследований яви лись основой для регистрации QVA149 более чем в 70 странах, включая страны Евросоюза, Канады, США, Японии и России [43][44][45][46]. Во всех проведенных исследованиях программы IGNITE QVA149 назна чалась с помощью дозированного порошкового ингалятора Бризхалер ® .…”

“…Во всех проведенных исследованиях программы IGNITE QVA149 назна чалась с помощью дозированного порошкового ингалятора Бризхалер ® . Препарат назначался 1 раз в сутки; в 1 капсуле содержалось 110 мкг индакатеро ла и 50 мкг гликопиррония (доставленная доза, т. е. доза на уровне мундштука ингалятора составляла 85 мкг и 43 мкг соответственно) [43,44,47]. При использовании комбинированной терапии индака теролом / гликопирронием значительно улучшались легочная функция, клинические симптомы, физи ческая выносливость, качество жизни, снижался риск обострений ХОБЛ [48][49][50][51][52][53][54][55][56][57].…”

Pharmacological management of chronic obstructive pulmonary disease

“…These agents have been shown to provide improvements in dyspnoea, healthrelated quality of life (QoL), lung function, rescue medication use, exercise capacity and exacerbation risk. [3][4][5][6][7] The decision as to which agent to start with is often based on patient preference, available finances (LABAs are usually less expensive than LAMAs) and preferred delivery device. There are many drug choices and brands to choose from (Table 1).…”

Neue Pharmaka zur Behandlung der chronisch-obstruktiven Lungenerkrankung (COPD)

“…LABA = Langwirksames β2-Mimetikum, LAMA = Langwirksames Anticholinergikum (long acting muscarinic antagonist), ICS = Inhalatives Kortikosteroid (inalative corticosteroid), GSK = GlaxoSmithKline. [24]. Die SPARK-Studie zeigte an 741 Patienten, dass die Fix-Kombination die Exazerbationsrate (primärer Ergebnisparameter) gegenüber der Glycopyrronium-(p = 0,0012) und der Tiotropium-(0,0017) Monotherapie signifikant senken und die FEV1 steigern (p < 0,0001) konnte.…”

“…Neue ICS/LABA-Fix-Kombinationen [24,27]. Das Besondere an dieser Entwicklung ist die nur einmal am Tag nöti-ge Inhalationstherapie.…”