Pharmacotherapeutic strategy for COPD patients: focus on dual bronchodilators DOI Creative Commons
A. I. Sinopalnikov

Meditsinskiy sovet = Medical Council, Год журнала: 2021, Номер 16, С. 38 - 44

Опубликована: Окт. 29, 2021

For two decades, the GOLD Initiative has consistently identified use of bronchodilators as a priority in pharmacotherapeutic strategy for COPD. The authors international and national clinical guidelines consider fixed combinations long-acting beta2-agonists (LABAs) muscarinic receptor antagonists (LAMAs) “first-line” drugs most patients with Numerous studies have shown that LABAs/LAMAs provide optimal bronchodilation play paramount role preventing exacerbations Outperforming placebo active controls, LABAs, LAMAs, inhaled glucocorticosteroids (ICS)/LABAs combination may differ their therapeutic potential. available evidence base currently does not allow to make an unambiguous choice favor one or another LABAs/ LAMAs combination. With appearance “triple” (ICS/LABAs/LAMAs) on pharmaceutical market, issue comparison “dual” become particularly acute. Currently data suggest therapy is considered starting treatment option COPD appropriate only subgroup higher baseline risk exacerbations: presence history ≥ 1, which required prescription systemic antibiotics and/or glucocorticosteroids, necessitated hospitalization during previous year. Thus, ICS-containing justified cases recurrent moderate single episodes severe exacerbations, despite continued administration LABAs/LAMAs, well certain categories whose inflammatory profile suggests “response” ICS.

Язык: Английский

Mechanisms, Pathophysiology and Currently Proposed Treatments of Chronic Obstructive Pulmonary Disease DOI Creative Commons
Sarah de Oliveira Rodrigues,

Carolina Medina Coeli da Cunha,

Giovanna Martins Valladão Soares

и другие.

Pharmaceuticals, Год журнала: 2021, Номер 14(10), С. 979 - 979

Опубликована: Сен. 26, 2021

Chronic obstructive pulmonary disease (COPD) is one of the leading global causes morbidity and mortality. A hallmark COPD progressive airflow obstruction primarily caused by cigarette smoke (CS). CS exposure an imbalance favoring pro- over antioxidants (oxidative stress), to transcription factor activation increased expression inflammatory mediators proteases. Different cell types, including macrophages, epithelial cells, neutrophils, T lymphocytes, contribute pathophysiology. Alteration in functions results generation oxidative microenvironment, which contributes progression. Current treatments include inhaled corticosteroids bronchodilator therapy. However, these therapies do not effectively halt Due complexity its pathophysiology, risk exacerbating symptoms with existing therapies, other specific effective treatment options are required. Therapies directly or indirectly targeting may be promising alternatives. This review briefly discusses provides update on development clinical testing novel treatments.

Язык: Английский

Процитировано

64
Blood eosinophils in COPD: friend or foe? DOI
Anastasia Papaporfyriou, Petros Bakakos,

Georgios Hillas

и другие.

Expert Review of Respiratory Medicine, Год журнала: 2021, Номер 16(1), С. 35 - 41

Опубликована: Ноя. 25, 2021

The pathogenesis of chronic obstructive pulmonary disease (COPD) is highly complex and the underlying cellular molecular mechanisms remain poorly understood.COPD has been traditionally associated with neutrophilic inflammation bronchi, but in last decade, studies have demonstrated that eosinophils may also migrate into lower airways patients COPD their increased numbers can be noticed during exacerbations as well stable disease. In this review, we present clinical characteristics eosinophilic COPD, role a biomarker-guided therapy COPD. A systematic research using database Pubmed up to February 2021 was performed. terms searched were inflammation, phenotypes, exacerbations, corticosteroids monoclonal antibodies COPD.Blood eosinophil levels show strong potential prognostic theragnostic biomarker management being at moment most reliable biomarker. lack certain cutoff value blood guidance for treatment ICS biologic therapies uncertainty regarding stability eosinophilia phenotype through course unmet dilemmas problems.

Язык: Английский

Процитировано

6
Use of single-inhaler triple therapy in the management of obstructive airway disease: Indian medical experts’ review DOI Creative Commons
Raja Dhar,

Deepak Talwar,

Sundeep Salvi

и другие.

ERJ Open Research, Год журнала: 2022, Номер 8(1), С. 00556 - 2021

Опубликована: Янв. 1, 2022

Obstructive airway disease (OAD), which includes COPD and asthma, is the leading cause of morbidity mortality in India. Long-acting bronchodilators (long-acting β2 agonists (LABAs) and/or long-acting muscarinic antagonists (LAMAs)) inhaled corticosteroids (ICS) have a vital role management patients with OAD. While symptom burden exacerbations are common amongst treated patients, poor adherence to inhaler therapy frequent challenge. Better treatment options that optimise control, improve quality life, reduce exacerbation risk desired. Triple (ICS/LABA/LAMA) recommended Global Initiative for Chronic Lung Disease (GOLD) 2021 guidelines symptomatic on ICS/LABA or LABA/LAMA, who at increased severe exacerbations. Similarly, add-on LAMA uncontrolled asthma medium- high-dose by Asthma (GINA) guideline. In real world, high-risk overlapping phenotypes exist, necessitate early initiation triple therapy. We aim provide an expert review use single-inhaler (SITT) OAD global Indian settings, knowledge from can be extrapolated appropriate patients. The population India may benefit optimisation SITT characterised high exacerbating OAD, nonsmoker asthma–COPD overlap.

Язык: Английский

Процитировано

4
The Impact of the Pay-for-Performance Program on the Outcome of COPD Patients in Taiwan After One Year DOI Creative Commons

Kuo-Chen Cheng,

Chih‐Cheng Lai, Cheng‐Yi Wang

и другие.

International Journal of COPD, Год журнала: 2022, Номер Volume 17, С. 883 - 891

Опубликована: Апрель 1, 2022

To investigate the impact of a multidisciplinary intervention on clinical outcomes patients with COPD.This study retrospectively extracted data enrolled in national pay-for-performance (P4P) program for COPD four hospitals. Only who received regular follow-up at least one year P4P between September 2018 and December 2020 were included.A total 1081 included this study. Among them, 424 (39.2%), 287 (26.5%), 179 (16.6%), 191 (17.7%) classified as Groups A, B, C, D, respectively. Dual therapy long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA) was most used inhaled bronchodilator baseline (n = 477, 44.1%) patients, followed by LAMA monotherapy 195, 18.0%), triple corticosteroid (ICS)/LABA/LAMA 184, 17.0%), ICS/LABA combination 165, 15.3%). After intervention, 374 (34.6%) 323 (29.9%) had their pre- post-bronchodilator-forced expiratory volume second (FEV1) increase more than 100 mL. Both Assessment Test (CAT) modified British Medical Research Council (mMRC) scores mean change -2.2 ± 5.5 -0.3 0.9, The improvement pulmonary function symptom score observed across groups. decreased number exacerbations only C not A B.This real-world demonstrated that could help improve outcome patients. It also showed us different view use dual therapy, which has lower cost Taiwan.

Язык: Английский

Процитировано

3
Clinical case of indacaterol / glycopyrronium bromide prescription in a patient with severe copd and concomitant pathology DOI Creative Commons

G. I. Ignatova,

В. Н. Антонов, I. A. Zakharova

и другие.

Meditsinskiy sovet = Medical Council, Год журнала: 2024, Номер 9, С. 27 - 30

Опубликована: Июнь 5, 2024

Combinations of inhaled glucocorticosteroids (IHGC) and long-acting bronchodilator inhalers (LABA inhalers) have been widely used to treat chronic obstructive pulmonary disease (COPD) over the past two decades. Prescription these drugs was based on large studies showing that this therapeutic regimen more effective compared placebo monotherapy. The article presents a clinical case report patient with severe course COPD coronary heart (CHD). Up-to-date concepts using dual therapy when switching from combinations (IHGC/LABA) is discussed. A artery disease, atrial fibrillation while IHGC/LABA had progressive respiratory failure, frequent exacerbations, acute symptomatology. As there evidence use has number limitations in combined cardiovascular diseases, first all arrhythmias, it recommended replace combination bronchodilators – muscarinic antagonist (LAMA) β agonist (LABA). resulted stabilization condition, reduction symptoms, absence complications. It concluded glycopyrronium bromide indacaterol prioritized COPD, including pathology; no increase events patients observed; Breezhaler inhaler user-friendly for advantages other delivery devices.

Язык: Английский

Процитировано

0
A study on the safety profile and clinical outcomes in patients using tulobuterol transdermal patch as an add on therapy in stable chronic obstructive pulmonary disease DOI Creative Commons

R Radhika,

Beena Thomas,

Ahmed Rafad

и другие.

Indian Journal of Immunology and Respiratory Medicine, Год журнала: 2022, Номер 7(1), С. 16 - 20

Опубликована: Апрель 4, 2022

Tulobuterol Transdermal Drug Delivery (TTD) may be beneficial in COPD management. We aimed to study the effect of adding TTD Triple Inhalation therapy (TI). Participants on and TI (TTD-TI cohort) and, only (TI were identified at out-patient pharmacy counter. There was no loss follow-up from 35 participants each enrolled cohorts. They assessed with Modified British Medical Research Council questionnaire (modified Council), Control Questionnaire (CCQ) Assessment Test (CAT). The latter two repeated end six months. change score compared Mann-Whitney-U test. Mean age years 63.4 65.7; 31% 20% females rest males TTD-TI cohorts respectively. All them had modified grade 2 or above. CCQ CAT scores comparable baseline. Change both statistically significant between (p<0.001). Median (minimum, maximum) -0.6(-2.8, 0) cohort 0.3(-2 1.2) cohort. -4(-16, -2) 2(-7 7) 5(14.3%) 7(20%) improved by would a subjective improvement addition tulobuterol transdermal patch triple inhalation for older persons COPD.

Язык: Английский

Процитировано

0
Pharmacotherapeutic strategy for COPD patients: focus on dual bronchodilators DOI Creative Commons
A. I. Sinopalnikov

Meditsinskiy sovet = Medical Council, Год журнала: 2021, Номер 16, С. 38 - 44

Опубликована: Окт. 29, 2021

For two decades, the GOLD Initiative has consistently identified use of bronchodilators as a priority in pharmacotherapeutic strategy for COPD. The authors international and national clinical guidelines consider fixed combinations long-acting beta2-agonists (LABAs) muscarinic receptor antagonists (LAMAs) “first-line” drugs most patients with Numerous studies have shown that LABAs/LAMAs provide optimal bronchodilation play paramount role preventing exacerbations Outperforming placebo active controls, LABAs, LAMAs, inhaled glucocorticosteroids (ICS)/LABAs combination may differ their therapeutic potential. available evidence base currently does not allow to make an unambiguous choice favor one or another LABAs/ LAMAs combination. With appearance “triple” (ICS/LABAs/LAMAs) on pharmaceutical market, issue comparison “dual” become particularly acute. Currently data suggest therapy is considered starting treatment option COPD appropriate only subgroup higher baseline risk exacerbations: presence history ≥ 1, which required prescription systemic antibiotics and/or glucocorticosteroids, necessitated hospitalization during previous year. Thus, ICS-containing justified cases recurrent moderate single episodes severe exacerbations, despite continued administration LABAs/LAMAs, well certain categories whose inflammatory profile suggests “response” ICS.

Язык: Английский

Процитировано

0