The cohort included 40,538 initiators of LAMA and 10,680 of LABA. The hazard ratio (HR) of exacerbation estimated using the Cox regression model, weighted by fine stratification of propensity scores. We identified a cohort of patients with COPD, new users of a LAMA or LABA (not combined with an inhaled corticosteroid (ICS)) during 2002-2018, age 50 or older, from the UK's CPRD database, and followed for one year. We compared the real world effectiveness of initial treatment with long-acting muscarinic agents (LAMA) versus long-acting beta 2-agonists (LABA) on the incidence of exacerbations in newly diagnosed patients.
Anoro Ellipta Summary of Product Characteristics, May 2014.The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations for the initial bronchodilator to use in newly diagnosed chronic obstructive pulmonary disease (COPD) are based on trials of patients with longstanding disease and treatment.Other commonly reported adverse effects included UTI, sinusitis, pharyngitis, upper respiratory tract infection, headache, cough, oropharyngeal pain, constipation and dry mouth. The most frequently reported adverse effect in patients receiving vilanterol/umeclidinium was nasopharyngitis. 1ĬOPD exacerbations were reduced by 50% with vilanterol/umeclidinium compared with placebo (HR 0.5, p=0.004), by 20% compared with umeclidinium (HR 0.8, p=0.391) and by 30% compared with vilanterol (HR 0.7, p=0.121). Similar outcomes were also observed with placebo and umeclidinium montherapy. Three six-month trials (total n=1747) showed that vilanterol/umeclidinium reduced the use of rescue medication compared with tiotropium. George’s Respiratory Questionnaire compared with tiotropium monotherapy. In one of the three comparator studies, the combination was associated with a statistically significant reduction in total score on the St. Improvements relating to health-related quality of life were also observed for vilanterol/umeclidinium in clinical studies. 1Īt week 24, a clinically meaningful increase in transition dyspnoea index (TDI) focal score (key secondary endpoint) was observed with vilanterol/umeclidinium compared with placebo (p<0.001). Vilanterol/umeclidinium was also shown to produce significantly greater improvements in lung function than tiotropium in two of three six-month active comparator studies (n=905, p<0.001 and n=410, p<0.001) and numerically greater improvements in the third (n=432, p=0.018). In one six-month study (n=1,532) significant improvements in lung function (as defined by change from baseline in trough FEV 1) at week 24 were observed for vilanterol/umeclidinium compared with placebo (p<0.001) and with each monotherapy treatment arm (p<0.001 vs vilanterol, p=0.004 vs umeclidinium). The clinical efficacy of once-daily vilanterol/umeclidinium was evaluated in eight phase III studies involving 6,835 adults with COPD. Its bronchodilatory action is complemented by that of umeclidinium, a long-acting muscarinic receptor antagonist (LAMA) which exerts its effects by competitively inhibiting the binding of acetylcholine to muscarinic receptors on airway smooth muscle. Vilanterol is a long-acting beta 2 agonist (LABA).
0 kommentar(er)
