Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same?
Bronchodilators provide improvements in lung function and reductions in symptoms and exacerbations, and are the mainstay of pharmacological management of chronic obstructive pulmonary disease (COPD). The Global Initiative for Chronic Obstructive Lung Disease strategy recommends the use of a combinat...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
The Korean Academy of Tuberculosis and Respiratory Diseases
2018-07-01
|
Series: | Tuberculosis and Respiratory Diseases |
Subjects: | |
Online Access: | https://e-trd.org/search.php?where=aview&id=10.4046/trd.2018.0040&code=0003TRD&vmode=FULL |
id |
doaj-4c1449b2541d495c93b9d2015677de6f |
---|---|
record_format |
Article |
spelling |
doaj-4c1449b2541d495c93b9d2015677de6f2020-11-25T02:03:00ZengThe Korean Academy of Tuberculosis and Respiratory DiseasesTuberculosis and Respiratory Diseases1738-35362005-61842018-07-01813198215Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same? Marc Miravitlles, M.D.0https://orcid.org/0000-0002-9850-9520Seungjae Baek, M.D.1Vatsal Vithlani, M.Pharm.2Rahul Lad, Ph.D.3Pneumology Department, Hospital Universitari Vall d'Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.Novartis Korea Ltd., Seoul, Korea.Novartis Healthcare Pvt. Ltd., Hyderabad, India.Novartis Healthcare Pvt. Ltd., Hyderabad, India.Bronchodilators provide improvements in lung function and reductions in symptoms and exacerbations, and are the mainstay of pharmacological management of chronic obstructive pulmonary disease (COPD). The Global Initiative for Chronic Obstructive Lung Disease strategy recommends the use of a combination of long-acting β2-agonist/long-acting muscarinic antagonists (LABA/LAMA) as the first-line treatment option in the majority of symptomatic patients with COPD. This review provides an indirect comparison of available LABA/LAMA fixed-dose combinations (FDCs) through discussion of important efficacy and safety data from the key literature, with the objective of providing physicians with a framework for informed decision-making. LABA/LAMA FDCs provided greater benefits compared with placebo and similar or greater benefits compared with tiotropium and salmeterol/fluticasone in improving lung function, dyspnea, health-related quality of life, reducing rescue medication use and preventing exacerbations, although with some variability in efficacy between individual FDCs; further, tolerability profiles were comparable among LABA/LAMA FDCs. However, there is a disparity in the amount of evidence generated for different LABA/LAMA FDCs. Thus, this review shows that all LABA/LAMA FDCs may not be the same and that care should be taken when extrapolating individual treatment outcomes to the entire drug class. It is important that physicians consider the efficacy gradient that exists among LABA/LAMA FDCs, and factors such as inhaler devices and potential biomarkers, when choosing the optimal bronchodilator treatment for long-term management of patients with COPD.https://e-trd.org/search.php?where=aview&id=10.4046/trd.2018.0040&code=0003TRD&vmode=FULLasianpulmonary diseasechronic obstructivedisease managementkorea |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marc Miravitlles, M.D. Seungjae Baek, M.D. Vatsal Vithlani, M.Pharm. Rahul Lad, Ph.D. |
spellingShingle |
Marc Miravitlles, M.D. Seungjae Baek, M.D. Vatsal Vithlani, M.Pharm. Rahul Lad, Ph.D. Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same? Tuberculosis and Respiratory Diseases asian pulmonary disease chronic obstructive disease management korea |
author_facet |
Marc Miravitlles, M.D. Seungjae Baek, M.D. Vatsal Vithlani, M.Pharm. Rahul Lad, Ph.D. |
author_sort |
Marc Miravitlles, M.D. |
title |
Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same? |
title_short |
Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same? |
title_full |
Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same? |
title_fullStr |
Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same? |
title_full_unstemmed |
Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same? |
title_sort |
optimal bronchodilation for copd patients: are all long-acting β2-agonist/long-acting muscarinic antagonists the same? |
publisher |
The Korean Academy of Tuberculosis and Respiratory Diseases |
series |
Tuberculosis and Respiratory Diseases |
issn |
1738-3536 2005-6184 |
publishDate |
2018-07-01 |
description |
Bronchodilators provide improvements in lung function and reductions in symptoms and exacerbations, and are the mainstay of pharmacological management of chronic obstructive pulmonary disease (COPD). The Global Initiative for Chronic Obstructive Lung Disease strategy recommends the use of a combination of long-acting β2-agonist/long-acting muscarinic antagonists (LABA/LAMA) as the first-line treatment option in the majority of symptomatic patients with COPD. This review provides an indirect comparison of available LABA/LAMA fixed-dose combinations (FDCs) through discussion of important efficacy and safety data from the key literature, with the objective of providing physicians with a framework for informed decision-making. LABA/LAMA FDCs provided greater benefits compared with placebo and similar or greater benefits compared with tiotropium and salmeterol/fluticasone in improving lung function, dyspnea, health-related quality of life, reducing rescue medication use and preventing exacerbations, although with some variability in efficacy between individual FDCs; further, tolerability profiles were comparable among LABA/LAMA FDCs. However, there is a disparity in the amount of evidence generated for different LABA/LAMA FDCs. Thus, this review shows that all LABA/LAMA FDCs may not be the same and that care should be taken when extrapolating individual treatment outcomes to the entire drug class. It is important that physicians consider the efficacy gradient that exists among LABA/LAMA FDCs, and factors such as inhaler devices and potential biomarkers, when choosing the optimal bronchodilator treatment for long-term management of patients with COPD. |
topic |
asian pulmonary disease chronic obstructive disease management korea |
url |
https://e-trd.org/search.php?where=aview&id=10.4046/trd.2018.0040&code=0003TRD&vmode=FULL |
work_keys_str_mv |
AT marcmiravitllesmd optimalbronchodilationforcopdpatientsarealllongactingb2agonistlongactingmuscarinicantagoniststhesame AT seungjaebaekmd optimalbronchodilationforcopdpatientsarealllongactingb2agonistlongactingmuscarinicantagoniststhesame AT vatsalvithlanimpharm optimalbronchodilationforcopdpatientsarealllongactingb2agonistlongactingmuscarinicantagoniststhesame AT rahulladphd optimalbronchodilationforcopdpatientsarealllongactingb2agonistlongactingmuscarinicantagoniststhesame |
_version_ |
1724949936558047232 |