Abstract
BackgroundIn 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.MethodsWe 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).ResultsNo 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.ConclusionsThe 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).
Highlights
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
Compared to LAMA or Long-acting β2 agonist (LABA) monotherapy, or an Inhaled corticosteroid (ICS)/LABA combination, LAMA/LABA co-treatment is superior in several aspects, including in the improvement of symptoms [2,3,4] and respiratory functions [3,4,5], and in the prevention of exacerbations [6,7,8]
Patients COPD outpatients aged 40 years old or over who attended the Department of Respiratory Medicine and Allergology at Kindai University Nara Hospital (Ikoma, Japan) between April 2017 and October 2019, and who were diagnosed as requiring LAMA and LABA, were included in this study
Summary
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. Long-acting muscarinic antagonists (LAMAs) and β2 agonists (LABAs) significantly improve respiratory function, dyspnea, and health status, and significantly reduce exacerbation rates [1]. Compared to LAMA or LABA monotherapy, or an Inhaled corticosteroid (ICS)/LABA combination, LAMA/LABA co-treatment is superior in several aspects, including in the improvement of symptoms [2,3,4] and respiratory functions [3,4,5], and in the prevention of exacerbations [6,7,8]. LAMA/LABA combination therapy using a single inhaler is recommended to enhance adherence, to reduce medical costs [5, 9, 10], and to optimize the synergistic effect of LAMA and LABA [11, 12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
