Patients prescribed LAMA-LABAs were more likely to have spirometry measurements at baseline than those prescribed ICS-LABAs (50.2% vs 30.7%) and were more likely to have received an index prescription from a pulmonologist (11.4% vs 4.5%).Īfter propensity-score matching, the 30,216 matched pairs were well-balanced: patients had an average age of 70 years and were evenly split between men and women.
Combo inhalers lama laba trial#
"Our study should not be interpreted as a decisive verdict on the conflicting clinical trial data in FLAME, IMPACT, and ETHOS, but rather as one piece of additional evidence to help shape clinical guidelines." "Because physicians frequently prescribe inhalers to patients who would not meet entry criteria for inclusion in COPD trials, the relative effectiveness of LAMA-LABA therapy compared with ICS-LABA therapy may differ in routine clinical practice," they continued. "Patients in our study appear to have substantially lower baseline risk than in all three of the other trials," Feldman and co-authors wrote in their discussion. Results of FLAME, meanwhile, were more in line with the current study, demonstrating a 22% reduction in the rate of first moderate or severe exacerbation with LAMA-LABA therapy. The IMPACT and ETHOS trials, for example, showed lower COPD exacerbation rates with ICS-LABA inhalers, despite more cases of pneumonia. Guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend LAMA-LABA inhalers as combination therapy for COPD, though randomized trials have offered up conflicting evidence, the researchers noted.
Combo inhalers lama laba plus#
“In summary, comparative data on trials of the new LAMA/ LABA FDC inhalers against one of the ICS/LABA combination inhalers (fluticasone plus salmeterol) are now available, and the results significantly favor the LAMA/ LABA inhalers in terms of efficacy (improvements in FEV1), patient-reported outcomes (TDI, mMRC), and quality of life measures (SGRQ),” concluded the study.LAMA-LABA therapy was also associated with a 20% reduction in first pneumonia hospitalization rates (HR 0.80, 95% CI 0.75-0.86), a finding that was consistent across prespecified subgroup and sensitivity analyses, according to their findings in JAMA Internal Medicine. Therefore, LAMA/LABA FDC is a more cost-effective option because of the reduction in long term adverse effects, including exacerbations, and the unpredictability of how much they can cost a COPD patient over time. LAMA/LABA inhalers decrease the risk of pneumonia by 33% to 67%, according to the analysis. “The new LAMA/LABA FDCs are now widely available and are a welcome addition to the options available for maintenance therapy in COPD.” “Given the significant adverse effects and increased incidence of pneumonia with long-term use of ICS, a favorable efficacy and safety profile of new LAMA/LABA FDCs versus ICS/LABA in COPD patients is very encouraging,” noted the researchers. Pnemonia rates, forced expiratory volume in 1 second (FEV 1), and other adverse events were also considered, and significant improvements were established in favor of the LAMA/LABA inhaler for COPD treatment.
Annual exacerbation rates among participants treated with indacaterol/glycopyrronium, one type of LAMA/LABA inhaler, were lower than the fluticasone/salmeterol group in a study. The analysis found significant decreases in exacerbation rates in the long duration trials with the dual bronchodilator. Long-term use of ICS has demonstrated increased incidence of pneumonia and other adverse effects. The new long-acting muscarinic antagonist and long-acting beta-agonist (LAMA/LABA) fixed dose combination (FDC) inhaler may be a better option than inhaled corticosteroids (ICS) for long-term use.Ī new review published by Dove Press analyzes data from previous studies that draw comparisons between new therapies and ICS/LABA. As more long-term therapies for chronic obstructive pulmonary disease (COPD) are being developed, the results and efficacy of different therapies vary.
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