Tiotropium and olodaterol fixed-dose combination<i>versus</i>mono-components in COPD (GOLD 2–4)

Buhl, Roland; Maltais, François; Abrahams, R; Bjermer, Leif; Derom, Eric; Ferguson, Gary T.; Fležar, Matjaž; Hébert, Jacques; McGarvey, Lorcan; Pizzichini, Emílio; Reid, Jim; Veale, Antony; Grönke, L; Hamilton, Alan; Korducki, Lawrence; Tetzlaff, Kay; Waitere-Wijker, Stella; Watz, Henrik; Bateman, Eric D.

doi:10.1183/09031936.00136014

Cited by 304 publications

(474 citation statements)

References 22 publications

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“…Nevertheless, a numerical difference in the CAT responder analysis was seen at week 8, with 47% of UMEC/VI-treated patients compared with 38% of TIO/OLO-treated patients obtaining clinically relevant improvements in symptoms and health-related QoL, with a similar response rate at week 4, in line with the primary study. This magnitude of improvement in symptom burden and QoL is consistent with treatment benefit on CAT and other patientreported outcomes seen on escalating therapy from one to two bronchodilators in patients with more advanced COPD [37,39,40].…”

Section: Discussionsupporting

confidence: 61%

Umeclidinium/Vilanterol Versus Tiotropium/Olodaterol in Maintenance-Naïve Patients with Moderate Symptomatic Chronic Obstructive Pulmonary Disease: A Post Hoc Analysis

Navarrete¹,

Boucot²,

Naya³

et al. 2018

Pulm Ther

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Section: Discussionsupporting

confidence: 61%

Umeclidinium/Vilanterol Versus Tiotropium/Olodaterol in Maintenance-Naïve Patients with Moderate Symptomatic Chronic Obstructive Pulmonary Disease: A Post Hoc Analysis

Navarrete¹,

Boucot²,

Naya³

et al. 2018

Pulm Ther

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“…In the current issue of the European Respiratory Journal, a novel candidate of this drug combination principle is presented by BUHL et al [7]. Two replicate phase III trials aimed to assess the efficacy and safety of inhaled tiotropium+olodaterol FDC 5/5 µg or 2.5/5 µg delivered via the Respimat Soft Mist inhaler compared with their individual mono-components in patients with moderate-to-very-severe COPD (Global Initiative for Chronic Obstructive Lung Disease stage 2-4) over 52 weeks.…”

Section: @Erspublicationsmentioning

confidence: 99%

Treatment of COPD and the TOnado trial: a tempest in a teapot?

Rabe

2015

Eur Respir J

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@ERSpublicationsDespite encouraging results for LABA/LAMA combination therapy in mild COPD, can we justify the additional costs? http://ow.ly/JVNb6The treatment of COPD follows a stepwise approach in practically all clinical practice guidelines and also current strategy documents [1]. Lung function impairment or low forced expiratory volume in 1 s (FEV1), once considered the single most important treatment parameter, now represents one of the target parameters for risk reduction in patients with chronic obstructive pulmonary disease (COPD), alongside exacerbations and respiratory symptoms, dyspnoea in particular. Furthermore, more holistic COPD approaches increasingly recognise the importance of physical activity and multimorbidity for disease outcome, mortality in particular [2].Long-acting bronchodilators, such as long-acting muscarinic antagonists (LAMAs) and long-acting β 2 -adrenoceptor agonists (LABAs) are the cornerstone of maintenance therapy for patients with moderate-to-severe COPD whose symptoms are not adequately controlled by short-acting bronchodilators alone [1,3]. The crucial role of these drugs has, in part, been helped by the fact that long-acting bronchodilators, and LAMAs in particular, have demonstrated efficacy in preventing COPD exacerbations, a good safety record and might even decrease mortality [4,5]. Also, the role of inhaled steroids for chronic treatment remains controversial and largely unresolved, despite recent efforts to identify a COPD phenotype that might benefit from this form of treatment [6].Since anticholinergic drugs and β 2 -adrenoceptor agonists differ in their pharmacology and their target receptors, but both act on the level of airway smooth muscle tone, combinations of these drug classes have been used and have been advocated for the treatment of COPD for decades. It comes therefore with little surprise that also the combination of LAMA and LABA is recommended for COPD patients not adequately controlled on a single bronchodilator drug alone [1] resulting in the development of an increasingly confusing variety of LAMA+LABA fixed-dose combinations (FDCs), and their respective generic clones [3].In the current issue of the European Respiratory Journal, a novel candidate of this drug combination principle is presented by BUHL et al. [7]. Two replicate phase III trials aimed to assess the efficacy and safety of inhaled tiotropium+olodaterol FDC 5/5 µg or 2.5/5 µg delivered via the Respimat Soft Mist inhaler compared with their individual mono-components in patients with moderate-to-very-severe COPD (Global Initiative for Chronic Obstructive Lung Disease stage 2-4) over 52 weeks. The authors hypothesised that combination therapy with tiotropium+olodaterol FDC would provide improvements in lung function, health-related quality of life (St George's Respiratory Questionnaire (SGRQ) total score at 24 weeks) and other COPD disease parameters compared to monotherapy with either component alone, and with a comparable safety profile.

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“…Lung deflation, therefore, represents an important underlying mechanism that drives the reduction in exacerbations, as well as the potentially beneficial effect on cardiac function and survival. The recently developed combinations of LABD may further improve these clinical outcomes by providing more effective bronchodilation and potential lung deflation compared to single agents (29)(30)(31).…”

mentioning

confidence: 99%

Does the Term “Deflators” Reflect More Accurately the Beneficial Effects of Long-acting Bronchodilators in COPD?

Κostikas

Siafakas

2016

COPD: Journal of Chronic Obstructive Pulmonary Disease

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Tiotropium and olodaterol fixed-dose combinationversusmono-components in COPD (GOLD 2–4)

Cited by 304 publications

References 22 publications

Umeclidinium/Vilanterol Versus Tiotropium/Olodaterol in Maintenance-Naïve Patients with Moderate Symptomatic Chronic Obstructive Pulmonary Disease: A Post Hoc Analysis

Umeclidinium/Vilanterol Versus Tiotropium/Olodaterol in Maintenance-Naïve Patients with Moderate Symptomatic Chronic Obstructive Pulmonary Disease: A Post Hoc Analysis

Treatment of COPD and the TOnado trial: a tempest in a teapot?

Does the Term “Deflators” Reflect More Accurately the Beneficial Effects of Long-acting Bronchodilators in COPD?

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