![]() ![]() ![]() In this cohort study, LAMA-LABA therapy was associated with improved clinical outcomes compared with ICS-LABA therapy, suggesting that LAMA-LABA therapy should be preferred for patients with COPD. These findings were robust across a range of prespecified subgroup and sensitivity analyses. The management of symptoms of chronic obstructive pulmonary disease (COPD) typically involves the use of inhaled long-acting bronchodilators. Compared with ICS-LABA use, LAMA-LABA use was associated with an 8% reduction in the rate of first moderate or severe COPD exacerbation (HR, 0.92 95% CI, 0.89-0.96) and a 20% reduction in the rate of first pneumonia hospitalization (HR, 0.80 95% CI, 0.75-0.86). Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models stratified on matched pairs.Īmong 137 833 patients (mean age, 70.2 years 69 530 female) (107 004 new ICS-LABA users and 30 829 new LAMA-LABA users), 30 216 matched pairs were identified for the primary analysis. Recently, two 'fixed triple' single-inhaler combinations of an inhaled corticosteroid (ICS), a long-acting 2-agonist (LABA), and a long-acting muscarinic antagonist (LAMA) have become available for patients with COPD.Logistic regression analysis was used to estimate propensity scores. 2022 Nov 8 11(22):6623.doi: 10.3390/jcm11226623. In a real-world clinical practice setting of COPD treatment, combined LABA-LAMA inhalers appear to be as effective as combined LABA-ICS inhalers in. Propensity score matching was used to control for confounding between the 2 groups. LABA/LAMA as First-Line Therapy for COPD: A Summary of the Evidence and Guideline Recommendations J Clin Med. The primary effectiveness outcome was first moderate or severe COPD exacerbation, and the primary safety outcome was first pneumonia hospitalization. The current analysis was performed from February 2021 to March 2023.Ĭombination LAMA-LABA inhalers (aclidinium-formoterol, glycopyrronium-formoterol, glycopyrronium-indacaterol, tiotropium-olodaterol, or umeclidinium-vilanterol) and combination ICS-LABA inhalers (budesonide-formoterol, fluticasone-salmeterol, fluticasone-vilanterol, or mometasone-formoterol). Patients younger than 40 years were excluded, as were those with a prior diagnosis of asthma. HOW ARE LAMAs USED LAMAs and LABAs should always be used with an inhaled corticosteroid. Patients must have had a diagnosis of COPD and filled a new prescription for a combination LAMA-LABA or ICS-LABA inhaler between January 1, 2014, and December 31, 2019. This was a 1:1 propensity score-matched cohort study using Optum's Clinformatics Data Mart, a large commercial insurance-claims database. To assess whether LAMA-LABA therapy is associated with reduced COPD exacerbations and pneumonia hospitalizations compared with ICS-LABA therapy in routine clinical practice. However, data from randomized clinical trials comparing these combination inhalers (LAMA-LABAs vs ICS-LABAs) have been conflicting and raised concerns of generalizability. Clinical guidelines on chronic obstructive pulmonary disease (COPD) recommend inhalers containing long-acting muscarinic antagonists (LAMAs) and long-acting β-agonists (LABAs) over inhalers containing inhaled corticosteroids (ICSs) and LABAs. ![]()
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