잠시만 기다려 주세요. 로딩중입니다.

Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same?

Tuberculosis and Respiratory Diseases 2018년 81권 3호 p.198 ~ 215
 ( Miravitlles Marc ) - CIBER de Enfermedades Respiratorias Hospital Universitari Vall d’Hebron Pneumology Department

 ( Baek Seung-Jae ) - Novartis Korea Ltd.
 ( Vithlani Vatsal ) - Novartis Healthcare Pvt. Ltd.
 ( Lad Rahul ) - Novartis Healthcare Pvt. Ltd.

Abstract

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.

키워드

Asian; Pulmonary Disease, Chronic Obstructive; Disease Management; Korea
원문 및 링크아웃 정보
등재저널 정보
KCI
KoreaMed
KAMS