المؤلفون: Christopher H, Fanta

المصدر: Medical Clinics of North America. 106:987-999

مصطلحات موضوعية: Adrenal Cortex Hormones, Administration, Inhalation, Quality of Life, Humans, Drug Therapy, Combination, Anti-Asthmatic Agents, Muscarinic Antagonists, General Medicine, Asthma, Bronchodilator Agents

الوصف: Providers caring for patients with severe, therapy-resistant asthma have novel options for their treatment. Administration of additional inhaled corticosteroids at the time of increased symptoms, a strategy referred to as anti-inflammatory rescue or AIR, has been proved to be effective in reducing the frequency of exacerbations and improving asthma-related quality of life. Long-acting muscarinic antagonists can be used in combination with long-acting beta-agonist bronchodilators for additional bronchodilation. The care of the patient with severe asthma must also include a strategy to help avoid severe, life-threatening asthma attacks, with intense patient education and a recommended survival toolkit.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6e9bd6271f2a2f28d15319000d961a79Test
https://doi.org/10.1016/j.mcna.2022.08.004Test

المؤلفون: Peter Ascanius Jacobsen, Kristian Kragholm, Christian Torp-Pedersen, Ulla Møller Weinreich

المصدر: Jacobsen, P A, Kragholm, K, Torp-Pedersen, C & Møller Weinreich, U 2022, ' Disability Retirement After First Admission with Acute Exacerbation of Chronic Obstructive Pulmonary Disease : A Danish Nationwide Registry Cohort Study Using a Retrospective Follow-Up Design ', International Journal of Chronic Obstructive Pulmonary Disease, vol. 17, pp. 2541-2551 . https://doi.org/10.2147/COPD.S377311Test

مصطلحات موضوعية: Adult, Retirement, Denmark, Muscarinic Antagonists, return to work, General Medicine, International Journal of Chronic Obstructive Pulmonary Disease, Middle Aged, early retirement, comorbidities, Denmark/epidemiology, chronic obstructive pulmonary disease, Cohort Studies, Pulmonary Disease, Chronic Obstructive, Adrenal Cortex Hormones, Administration, Inhalation, Pulmonary Disease, Chronic Obstructive/diagnosis, Humans, Drug Therapy, Combination, Registries, Adrenergic beta-2 Receptor Agonists, Follow-Up Studies, Retrospective Studies

الوصف: Peter Ascanius Jacobsen,1,2 Kristian Kragholm,2,3 Christian Torp-Pedersen,4 Ulla Møller Weinreich1,2 1Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; 2The Clinical Institute, Aalborg University, Aalborg, Denmark; 3Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; 4Department of Clinical Research, Hillerød Hospital, Hillerød, DenmarkCorrespondence: Peter Ascanius Jacobsen, Department of Respiratory Diseases, Aalborg University Hospital, Mølleparkvej 4, Aalborg, DK-9100, Denmark, Tel +4597664800, Email Mail:peter.jacobsen@rn.dkIntroduction: Many chronic obstructive pulmonary disease (COPD) patients below retirement age are outside the workforce. The existing knowledge about association between acute exacerbation of COPD (AECOPD) and disability retirement is limited.Aim: The aim of this study is to explore disability retirement in COPD patients 3 years following first-ever AECOPD.Methods: This retrospective registry-based follow-up cohort study design is based on nationwide Danish registry data. Patients admitted to the hospital for the first time between 1999 and 2017 with AECOPD and age between 35 and 59 years, active in the workforce, were included in the study. Socio-demographics, comorbidities and inhaled medication use were explored. COPD patients’ hazard ratio of disability retirement during 3-year follow-up was calculated. Cox regression was used to examine the effects of covariates on disability retirement.Results: A total of 4032 patients were included in the study. During follow-up, 17.2% (692/4032) experienced disability retirement from the workforce. Factors associated with disability retirement were expressed as hazard ratio (95% confidence intervals): Higher age (ref. age 46– 50: Age 51– 55, 1.42, (1.12– 1.81); age 56– 59, 1.37 (1.08– 1.74)); living alone (1.34 (1.14– 1.56)); number of comorbidities for 1, 2, and 3 comorbidities (1.36 (1.14– 1.62), 1.57 (1.19– 2.07), 1.77 (1.20– 2.60)); emphysema (2.01 (1.44– 2.79)); depression (1.60 (1.12– 2.28)); cardiac comorbidity (1.38 (1.07– 1.78)); triple inhalation therapy (2.76 (2.20– 3.47)); ICS + LAMA or ICS + LABA treatment (1.82 (1.48– 2.23)); and ICS treatment (1.49 (1.17– 1.90)). Higher educational level was associated with a significantly reduced risk of disability retirement, medium, short higher and long higher educational level, relative to low education level (0.78 (0.67– 0.91), 0.63 (0.48– 0.83) and 0.27 (0.12– 0.60)).Conclusion: Patients vulnerable to disability retirement are patients with markers of severe COPD, comorbidities, and social vulnerability.Keywords: chronic obstructive pulmonary disease, return to work, early retirement, comorbidities

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الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a681f62d02fbabb280d799f0930c8ea0Test
https://doi.org/10.2147/copd.s377311Test

المؤلفون: Afisi S. Ismaila, Katrin Haeussler, Alexandrosz Czira, Ji-Hee Youn, Mia Malmenäs, Nancy A. Risebrough, Jatin Agarwal, Maria Nassim, Raj Sharma, Chris Compton, Claus F. Vogelmeier, MeiLan K. Han, David M. G. Halpin

المصدر: Advances in Therapy. 39:3957-3978

مصطلحات موضوعية: Adult, Quinuclidines, Network Meta-Analysis, Muscarinic Antagonists, General Medicine, Chlorobenzenes, Bronchodilator Agents, Androstadienes, Drug Combinations, Pulmonary Disease, Chronic Obstructive, Adrenal Cortex Hormones, Administration, Inhalation, Budesonide, Formoterol Fumarate Drug Combination, Fluticasone, Humans, Pharmacology (medical), Benzyl Alcohols

الوصف: Randomized controlled trials (RCTs) comparing triple therapies (inhaled corticosteroid [ICS], long-acting βThis NMA was conducted on the basis of a systematic literature review (SLR), which identified RCTs in adults aged at least 40 years with COPD. The RCTs compared different ICS/LABA/LAMA combinations or an ICS/LABA/LAMA combination with any dual therapy (ICS/LABA or LAMA/LABA). Outcomes of interest included forced expiratory volume in 1 s (FEVThe NMA was informed by five trials reporting FEVThe findings of this NMA suggest favorable efficacy with single-inhaler triple therapy comprising FF/UMEC/VI. Further analysis is required as additional evidence becomes available.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::180a1885fc8a3e1ac1f7f5e7ce63d963Test
https://doi.org/10.1007/s12325-022-02231-0Test

المؤلفون: Marcus Sim, Anthony Yii, Xiaomeng Xu, Priti Bahety, Chee Hong Loh, Aldo Amador Navarro Rojas, Dominique Milea, Augustine Tee

المصدر: International Journal of Chronic Obstructive Pulmonary Disease. 17:1349-1363

مصطلحات موضوعية: Adult, Pulmonary Disease, Chronic Obstructive, Singapore, Adrenal Cortex Hormones, Administration, Inhalation, Disease Progression, Humans, Drug Therapy, Combination, Muscarinic Antagonists, General Medicine, International Journal of Chronic Obstructive Pulmonary Disease, Adrenergic beta-2 Receptor Agonists, Bronchodilator Agents

الوصف: Marcus Sim,1 Anthony Yii,1 Xiaomeng Xu,2 Priti Bahety,3 Chee Hong Loh,1 Aldo Amador Navarro Rojas,4 Dominique Milea,2 Augustine Tee1 1Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore, Singapore; 2Value Evidence & Outcomes, Greater China and Intercontinental, GSK, Singapore, Singapore; 3Medical Affairs, GSK, Singapore, Singapore; 4Respiratory & Specialty Medical Lead, Greater China and Intercontinental, GSK, Singapore, SingaporeCorrespondence: Marcus Sim, Department of Respiratory and Critical Care Medicine, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore, Tel +65 6788 8833, Email marcus.sim@mohh.com.sgIntroduction: There is limited real-world evidence regarding clinical practice for chronic obstructive pulmonary disease (COPD) in Singapore. We compared baseline clinical characteristics and evaluated outcomes in patients with COPD who initiated treatment with either a long-acting muscarinic antagonist (LAMA) or a LAMA and a long-acting β2-agonist (LAMA+LABA).Methods: This was a single-center observational study at Changi General Hospital, Singapore. Routine clinical data (hospital visits, case management, lung function, laboratory/imaging results, medication orders) were collected and compiled into a data warehouse. Eligible patients with COPD were ≥ 40 years old and newly prescribed LAMA or LAMA+LABA during the enrollment period. Patient characteristics in the baseline period (6 months) were compared between treatments. Clinical worsening was measured as a composite endpoint, defined as the first of a change in maintenance treatment class or a moderate-to-severe exacerbation during follow-up (12 months).Results: In total, 261 patients were included in the baseline period (LAMA: 73; LAMA+LABA: 188). In the baseline period, patients receiving LAMA+LABA versus LAMA had significantly lower body mass index, higher COPD Assessment Test score and worse lung function, and numerically higher exacerbation history. Prevalence of comorbidities was similar between treatment groups. In follow-up, high rates of clinical worsening were observed regardless of treatment regimen (LAMA: 38/73 [52%]; LAMA+LABA: 86/188 [46%]). Median time-to-clinical worsening was 340 days for the LAMA cohort and the raw median 154 days (interquartile range: 44– 225) for the LAMA+LABA cohort. Median medication dispensation rate (0.86; interquartile range: 0.56– 1.00) was similar between treatments.Conclusion: Patients initiating treatment with LAMA+LABA had more severe COPD than patients prescribed LAMA. The proportion of patients experiencing clinical worsening was similarly high in both cohorts, suggesting that early identification and treatment optimization are necessary.Keywords: COPD treatment, database analysis, dual bronchodilator, LABA, LAMA, inhaler prescription

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الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d81cd81e8fcc1d0b49e83c9e381fe220Test
https://doi.org/10.2147/copd.s357820Test

المؤلفون: Ding,Yanling, Sun,Lina, Wang,Ying, Zhang,Jing, Chen,Yahong

المصدر: International Journal of Chronic Obstructive Pulmonary Disease. 17:1051-1067

مصطلحات موضوعية: Pulmonary Disease, Chronic Obstructive, Adrenal Cortex Hormones, Administration, Inhalation, Quality of Life, Humans, Drug Therapy, Combination, Muscarinic Antagonists, General Medicine, International Journal of Chronic Obstructive Pulmonary Disease, Adrenergic beta-2 Receptor Agonists, Bronchodilator Agents, Randomized Controlled Trials as Topic

الوصف: Yanling Ding *, Lina Sun *, Ying Wang, Jing Zhang, Yahong Chen Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jing Zhang; Yahong Chen, Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China, Tel +86 13-8104-57631, Email jing_amy@126.com; chenyahong@vip.sina.comBackground: Several large randomized clinical trials (RCTs) have assessed the efficacy and safety of inhaled corticosteroid (ICS) combination regimens versus non-ICS therapy in patients with chronic obstructive pulmonary disease (COPD) at increased risk of exacerbation risk with mixed results.Methods: We performed a systematic literature review and meta-analysis of RCTs comparing the effect of ICS-containing combination therapy and non-ICS regimen in patients with COPD.Results: A total of 54 RCTs (N = 57,333) reported treatment effects on various outcomes and were eligible for inclusion. Overall, the number of patients experiencing moderate/severe exacerbations was significantly lower for ICS-containing combination therapy versus non-ICS therapy (RR: 0.86 [95% CI: 0.80– 0.93]). The annual rate of exacerbations was also significantly reduced by 22% (0.78 [0.72– 0.86]) with ICS-containing versus non-ICS therapy. The annual rate of exacerbations requiring hospitalisation was reduced by 31% versus non-ICS therapy (0.69 [0.54– 0.88]); similar reduction was observed for exacerbations requiring oral steroids (0.69 [0.66– 0.73]). Overall, the effect on trough FEV1 was comparable between ICS-containing and non-ICS therapies (follow-up: 6– 52 weeks); however, a significant improvement in lung function (trough FEV1) was observed for ICS/LABA versus LABA (MD: +0.04 L [0.03− 0.05]) and ICS/LABA/LAMA versus LAMA (MD: +0.09 L [0.05− 0.13]) regimens. In addition, a significant improvement in QoL was observed with ICS-containing versus non-ICS therapy (MD in SGRQ score: − 0.90 [− 1.50, − 0.31]).Conclusion: This meta-analysis demonstrated that a wide range of patients with COPD could benefit from dual and triple ICS-containing therapy.Keywords: meta-analysis, chronic obstructive pulmonary disease, inhaled corticosteroid, dual therapy, triple therapy, exacerbation

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الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1a62574d7492eaffe0cbd3a2a6185d76Test
https://doi.org/10.2147/copd.s347588Test

المؤلفون: David Mannino, James Siddall, Mark Small, Adam Haq, Marjorie Stiegler, Michael Bogart

المصدر: International Journal of Chronic Obstructive Pulmonary Disease. 17:749-761

مصطلحات موضوعية: Adult, Male, Adolescent, education, Muscarinic Antagonists, General Medicine, International Journal of Chronic Obstructive Pulmonary Disease, United States, Bronchodilator Agents, Pulmonary Disease, Chronic Obstructive, Cross-Sectional Studies, Adrenal Cortex Hormones, Physicians, Administration, Inhalation, Humans, Female, Practice Patterns, Physicians', Adrenergic beta-2 Receptor Agonists, Aged

الوصف: David Mannino,1 James Siddall,2 Mark Small,2 Adam Haq,2 Marjorie Stiegler,3 Michael Bogart3 1Department of Medicine, University of Kentucky, Lexington, KY, USA; 2Respiratory DSP Franchise, Adelphi Real World, Bollington, UK; 3US Value Evidence and Outcomes, GlaxoSmithKline plc, Durham, NC, USACorrespondence: Michael Bogart, US Value Evidence and Outcomes, GlaxoSmithKline plc, 5 Moore Dr, Research Triangle Park, Durham, NC, USA, Tel +19198897413, Email michael.r.bogart@gsk.comPurpose: There is a high prevalence of chronic obstructive pulmonary disease (COPD) in the United States (US). Although guidelines are available for the treatment of COPD, evidence suggests that management of COPD in clinical practice is not always aligned with this guidance. This study aimed to further understand the current use of COPD maintenance medication in the US.Patients and Methods: This study was an analysis of data from the Adelphi Respiratory Disease Specific Programme (DSP™) 2019. Point-in-time data were collected from participating US physicians and their COPD patients. Physicians were either primary care physicians (PCPs) or pulmonologists, with a minimum workload of ≥ 3 COPD patients per month. Patients were aged ≥ 18 years with a physician-confirmed diagnosis of COPD.Results: In total, 171 physicians completed the survey (92 PCPs and 79 pulmonologists). Mean patient age was 66.4 years, 45% were female, with moderate COPD in 49.4% of patients and severe/very severe in 19.3%. Pulmonologists more frequently prescribed dual bronchodilation and triple therapy than PCPs, whereas inhaled corticosteroid/long-acting β2-agonist was more frequently prescribed by PCPs than pulmonologists. For both physician types, the most common reason for prescribing their patients’ current treatment was 24-hour symptom relief. The majority of PCPs (70.1%) and pulmonologists (71.9%) reported referring to COPD guidelines when making treatment decisions.Conclusion: Prescribing patterns for COPD patients were found to differ between PCPs and pulmonologists. Improved physician understanding of how to tailor treatment for each patient, based on current symptoms and exacerbation risk, could help optimize patient care in COPD.Keywords: COPD, inhaled corticosteroids, long-acting β2-agonist, long-acting muscarinic antagonist, maintenance therapy, survey

وصف الملف: text/html

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::551ee7a2d2ad29163795f46154132720Test
https://doi.org/10.2147/copd.s340794Test

المؤلفون: Hajime Yoshisue, Takayoshi Sasajima, Noriko Nakamura, Chihiro Kato

المصدر: Internal Medicine. 61:789-800

مصطلحات موضوعية: medicine.medical_specialty, Population, Postmarketing surveillance, Muscarinic Antagonists, Quinolones, Pulmonary function testing, Pulmonary Disease, Chronic Obstructive, FEV1/FVC ratio, Japan, Forced Expiratory Volume, Internal medicine, Product Surveillance, Postmarketing, Internal Medicine, Humans, Medicine, education, Adverse effect, Adrenergic beta-2 Receptor Agonists, Aged, education.field_of_study, COPD, business.industry, Incidence (epidemiology), General Medicine, medicine.disease, Glycopyrrolate, Bronchodilator Agents, Drug Combinations, Treatment Outcome, Indans, Indacaterol, business, medicine.drug

الوصف: Objective To evaluate the long-term safety and efficacy of indacaterol/glycopyrronium (IND/GLY) in patients with COPD in a real-world setting in Japan. Methods This 52-week, multicentre, post-marketing surveillance conducted in Japan between December 2013 and August 2019 included patients using IND/GLY for the first time to relieve airway obstructive disorder-related symptoms. Safety outcomes included the incidence of adverse events (AEs), serious AEs (SAEs), adverse drug reactions (ADRs), and serious ADRs during the 52-week period. The incidence of priority variables, including cardiovascular/cerebrovascular (CCV) AEs, β-adrenergic-related or anticholinergic AEs and cough, was also assessed. Safety outcomes were also evaluated in elderly patients. Efficacy outcomes included a physician's global assessment, COPD assessment test (CAT) and lung function test. Results Of the 1,167 patients registered, 1,108 were included in the safety and efficacy analysis. In the safety analysis population, the incidence of AEs was 13.54%, that of SAEs was 4.69%, that of ADR was 3.61%, and that of serious ADRs was 0.36% over 52 weeks. CCV AEs, β-adrenergic-related and anticholinergic AEs and cough were reported as 2.62%, 1.99% and 0.63%, respectively. The physician's global assessment showed that the overall response rate at the last assessment was 74.19%. The mean (95% confidence interval) CAT scores decreased from the start of treatment to Week 52 with IND/GLY (-6.9 [-7.8 to -6.1]). The lung function (FEV1 and FVC) improved over time from the start of IND/GLY to Week 52. Conclusion IND/GLY demonstrated a good long-term safety profile in a real-world setting in Japanese patients with COPD, with beneficial effects in terms of the lung function and symptoms in clinical use.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ea71255ae189ab585b88417b04492132Test
https://doi.org/10.2169/internalmedicine.7845-21Test

المؤلفون: John Cookson, Ferdinand Jonsson

المصدر: Lancet (London, England). 400(10369)

مصطلحات موضوعية: Cholinergic Agents, Humans, General Medicine, Muscarinic Antagonists, Receptors, Muscarinic, Antipsychotic Agents

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::75d16c320c66a0f61fd8f38486aca0cdTest
https://pubmed.ncbi.nlm.nih.gov/36528376Test

المؤلفون: Kevin, Baumgartner, Michelle, Doering And, Michael E, Mullins

المصدر: Clinical toxicology (Philadelphia, Pa.). 60(12)

مصطلحات موضوعية: Analgesics, Opioid, Narcotics, Alcoholism, Serotonin Syndrome, Humans, Hypnotics and Sedatives, General Medicine, Muscarinic Antagonists, Toxicology, Dexmedetomidine, Substance Withdrawal Syndrome

الوصف: Dexmedetomidine is an alpha-2 adrenoceptor agonist which is widely used for sedation. Dexmedetomidine does not suppress the respiratory drive and produces a state of cooperative sedation; it may be associated with beneficial outcomes in the general critical care population. The role of dexmedetomidine in the treatment of toxicologic conditions (excluding alcohol withdrawal) is unclear.To critically assess and summarize the literature regarding the use of dexmedetomidine in toxicologic conditions other than alcohol withdrawal.We performed a systematic review of the medical literature to identify all existing evidence regarding the use of dexmedetomidine for toxicologic conditions. We excluded reviews and commentary, studies reporting exclusively on alcohol withdrawal, and studies reporting the use of dexmedetomidine to treat iatrogenic sedative withdrawal in the intensive care unit. We also performed a review of the Toxicology Investigators Consortium (ToxIC) database for patients treated with dexmedetomidine.We identified 98 studies meeting inclusion criteria; 87 of these were case reports or case series, representing 99 unique cases. Eleven articles with other designs were identified, which included 138 patients treated with dexmedetomidine for toxicologic conditions. Ninety-three cases from the ToxIC registry met inclusion criteria. Common indications for dexmedetomidine included stimulant intoxication, sedative withdrawal, serotonin syndrome, antimuscarinic toxidrome, opioid withdrawal, and cannabinoid intoxication. Dexmedetomidine was usually administered by continuous infusion; bolus administration was reported in a minority of cases. Adverse effects were uncommon. The quality of evidence was generally low, given the preponderance of case reports, the rate of missing or poorly reported data, and the near-universal co-administration of other sedatives.Fifty-nine patients with stimulant poisoning were treated with dexmedetomidine. There was reasonably good evidence that dexmedetomidine was helpful in the treatment of stimulant poisoning.Twenty-two patients with sedative withdrawal were treated with dexmedetomidine. Several case reports of very high-quality suggested efficacy of dexmedetomidine for this indication, particularly for baclofen withdrawal.Twenty-six patients with serotonin syndrome were treated with dexmedetomidine. This evidence was of lower quality due to missing clinical details, potential overdiagnosis of serotonin syndrome, and near-universal concomitant treatment with other sedatives.Forty-two patients with antimuscarinic poisoning were treated with dexmedetomidine. This evidence was of low quality and was limited by infrequent use of the preferred antidote, physostigmine.Forty-four patients with opioid withdrawal were treated with dexmedetomidine. This evidence was of low quality due to missing clinical details and near-universal concomitant treatment with other agents. The one high-quality trial reported the use of dexmedetomidine in ultra-rapid opioid detoxification, which is not indicated in modern practice.Five patients with cannabinoid intoxication were treated with dexmedetomidine. No definite conclusion can be drawn from the limited available evidence.It is important to distinguish between the use of dexmedetomidine as a general sedative, which is likely to increase as the overall utilization of dexmedetomidine in critical care settings increases, and the use of dexmedetomidine as a specific pharmacologic treatment for a toxicologic condition. Well-established pharmacologic data from animal and human studies suggest dexmedetomidine counteracts stimulant-induced norepinephrine release. The mechanism by which dexmedetomidine treats sedative withdrawal is unclear. Some animal data show that dexmedetomidine may indirectly suppress serotonin release, which may suggest a role for dexmedetomidine in this condition.There is a small and generally low-quality body of evidence which suggests that dexmedetomidine may be helpful in the treatment of certain toxicologic conditions, particularly stimulant intoxication and sedative withdrawal. Further high-quality research is needed to clarify the role of dexmedetomidine in patients with toxicologic conditions.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::443dda894a303b6690158f62cb6f918dTest
https://pubmed.ncbi.nlm.nih.gov/36346349Test

المؤلفون: Maria Gabriella Matera, Barbara Rinaldi, Carmela Belardo, Mario Cazzola

المساهمون: Matera, M. G., Rinaldi, B., Belardo, C., Cazzola, M.

المصدر: Expert review of clinical pharmacology. 15(11)

مصطلحات موضوعية: comparative studie, General Medicine, Muscarinic Antagonists, lamas, Bronchodilator Agents, fixed-dose combination, Drug Combinations, Pulmonary Disease, Chronic Obstructive, Administration, Inhalation, Quality of Life, COPD, Humans, Pharmacology (medical), laba, General Pharmacology, Toxicology and Pharmaceutics, guideline, Adrenergic beta-2 Receptor Agonists

الوصف: Introduction Long-acting muscarinic receptor antagonist (LAMA)/beta(2)-agonist (LABA) combinations represent a significant improvement in the treatment of chronic obstructive pulmonary disease (COPD) due to their remarkable ability to improve lung function, dyspnea, quality of life, and exercise capacity compared to mono-components. Areas covered This article aims to report the latest information on the clinical impact of dual bronchodilation in COPD. Expert opinion The available data supports the use of inhaled LAMA/LABA FDCs in treating COPD patients, particularly those with severe or very severe disease. These combinations provide short - and long-term benefits to COPD patients without increasing the dose of the single components, which reduces the risk of adverse events while ensuring an improvement in clinical efficacy. Unfortunately, head-to-head studies comparing all exiting LABA/LAMA combinations are relatively few. Since each available LAMA/LABA combination has a unique efficacy/safety profile that must be considered for personalized COPD therapy, further randomized controlled trials and real-world studies lasting at least one year are needed to assess what differences, if any, there are in terms of clinical outcomes when dual LAMA/LABA inhalers are compared to LAMA or LABA single inhalers, and to compare different LAMA/LABA FDCs.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bd901cf3259325eddefb66ba93475241Test
https://pubmed.ncbi.nlm.nih.gov/36324269Test