The effect of Combination Therapy of Inhaled Corticosteroids and Long-acting Beta2-agonists on Acute Exacerbation in Moderate to Severe COPD Patients

2005 ◽  
Vol 59 (2) ◽  
pp. 164
Author(s):  
Hye Cheol Jeong ◽  
Eun Sil Ha ◽  
Jin Yong Jung ◽  
Kyung Ju Lee ◽  
Seung Hyeun Lee ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Acute Exacerbation ◽  
Inhaled Corticosteroids ◽  
Copd Patients ◽  
Long Acting ◽  
Severe Copd

scholarly journals Analisi di costo efficacia nella terapia della BPCO

2005 ◽  
Vol 6 (4) ◽  
pp. 277-287
Author(s):  
Sergio Iannazzo ◽  
Lorenzo Pradelli ◽  
Roberto W. Dal Negro ◽  
Mario Eandi
Keyword(s):  
Current Practice ◽  
Inhaled Corticosteroids ◽  
National Health System ◽  
Indirect Costs ◽  
Published Data ◽  
Widespread Application ◽  
Progression Model ◽  
Copd Patients ◽  
Long Acting ◽  
Severe Copd

Current practice guidelines for the treatment of COPD recommend the use of combined inhaled corticosteroids and long-acting bronchodilators in severe and very severe patients (GOLD stages III and IV). OBJECTIVES: To analyze the economical and clinical impact of this recommendation, the affordability of its widespread application, as well as the relative pharmacoeconomical performance of the available options for severe and very severe COPD in Italy. METHODS: Published data on the Italian COPD population were fitted in a disease progression model based on a Markov chain representing severity stages and death. Alternative therapeutic options (salmeterol/ fluticasone - SF, formoterol/budesonide - FB, salmeterol alone - S, fluticasone alone - F and control - C) were represented as competing arms in a decision tree. Efficacy data from international trials were expressed in terms of risk reduction. Clinical parameters used were number of exacerbations and symptom-free days. Direct and indirect costs were considered and valued according to present prices and tarifs. The analyses were conducted from National Health System, societal and patient perspectives with time horizons of 1,5, and 10 years, and lifelong. RESULTS: The yearly total direct costs of treating COPD patients in Italy is estimated in approximately 7 billion Euro, with a mean cost/patient/year around 2,400 Euro. Mean survival of the cohort is 11,5 years. The C and F strategies are dominated (i.e. are associated with worse outcomes and higher costs) by all alternatives. S/F and F/B are the most effective strategies, with a slight clinical superiority of the latter, but are also marginally more expensive than S. Incremental cost/effectiveness of S/F vs. S is 679,55 Euro/avoided exacerbation and 3,31Euro/gained symptom-free day. CONCLUSIONS: The recommended use of combined inhaled corticosteroids and long-acting bronchodilators for severe and very severe COPD patients, as compared with current practice, has the potential of improving clinical outcomes without increasing health care costs.

scholarly journals Escalation Time to Open Triple Combination Therapy from the Initiation of LAMA versus ICS/LABA in COPD Management: Findings from Comparing the Incidence of Tiotropium and ICS/LABA in Real-World Use in South Korea (CITRUS) Study

2021 ◽  
Vol 11 (12) ◽  
pp. 1325
Author(s):  
Ye Jin Lee ◽  
Chin Kook Rhee ◽  
Yong Il Hwang ◽  
Kwang Ha Yoo ◽  
So Eun Lee ◽  
...  
Keyword(s):  
Combination Therapy ◽  
South Korea ◽  
Triple Therapy ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Triple Combination ◽  
Obstructive Pulmonary Disease ◽  
Triple Combination Therapy ◽  
Copd Patients ◽  
Long Acting

Background: bronchodilators are the key treatment for chronic obstructive pulmonary disease (COPD), however, inhaled corticosteroids (ICSs)/long-acting β2-agonists (LABA) are widely prescribed. We compared the escalation time to open triple combination therapy between long-acting muscarinic receptor antagonists (LAMA) and ICS/LABA in COPD management. Methods: this retrospective study included COPD patients selected from the National Health Insurance Service of South Korea from January 2005 to April 2015. The primary outcome was the escalation time to triple therapy in patients who initially received LAMA or ICS/LABA. Other outcomes included risk factors predisposing escalation to triple combination therapy. Results: a total of 2444 patients were assigned to the LAMA or ICS/LABA groups. The incidences of triple combination therapy in the LAMA and ICS/LABA groups were 81.0 and 139.8 per 1000 person-years, respectively (p < 0.001); the median times to triple therapy escalation were 281 and 207 days, respectively (p = 0.03). Treatment with ICS/LABA showed a higher risk of triple therapy escalation compared to LAMA (hazard ratio (HR), 1.601; 95% confidence interval (CI), 1.402–1.829). The associated risk factor was male sex. (HR, 1.564; 95% CI, 1.352–1.809). Conclusions: the initiation of COPD treatment with LAMA is associated with a reduced escalation time to triple therapy compared with ICS/LABA.

Current opportunities of inhaled corticosteroid therapy in patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 31 (1) ◽  
pp. 75-87
Author(s):  
I. V. Leshchenko ◽  
A. S. Meshcheryakova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Fixed Combination ◽  
Chronic Obstructive ◽  
Delivery Device ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Long Acting ◽  
Blood Eosinophils

Chronic obstructive pulmonary disease (COPD) is the leading cause of death in the structure of respiratory diseases. The problem of rational pharmacotherapy of COPD have attracted attention of the medical scientific society for many years. The understanding of the pathogenesis of the disease has deepened and approaches to the therapy have changed. Some COPD patients need regular fixed-combination therapy: long-acting bronchodilators (LABD) and inhaled corticosteroids (ICS) in order to prevent exacerbations and reduce the severity of symptoms of the disease. Blood eosinophils count is one of criteria for choosing regular therapy. The appearance of fixed triple combinations of ICS/LABD increased the effectiveness of COPD therapy, and a new delivery device for fixed combination of budesonide/formoterol makes it possible to use ICS successfully in the most severe patients.

Molecular Mechanisms of Combination Therapy With Inhaled Corticosteroids and Long-Acting β-Agonists

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 1095-1100 ◽  
Author(s):  
Judith L. Black ◽  
Brian G.G. Oliver ◽  
Michael Roth
Keyword(s):  
Combination Therapy ◽  
Molecular Mechanisms ◽  
Inhaled Corticosteroids ◽  
Long Acting
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