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.
As more long-term therapies for chronic obstructive pulmonary disease (COPD) are being developed, the results and efficacy of different therapies vary. 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.
A new review published by Dove Press analyzes data from previous studies that draw comparisons between new therapies and ICS/LABA. Long-term use of ICS has demonstrated increased incidence of pneumonia and other adverse effects.
The analysis found significant decreases in exacerbation rates in the long duration trials with the dual bronchodilator. 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. Pnemonia rates, forced expiratory volume in 1 second (FEV1), and other adverse events were also considered, and significant improvements were established in favor of the LAMA/LABA inhaler for COPD treatment.
“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. “The new LAMA/LABA FDCs are now widely available and are a welcome addition to the options available for maintenance therapy in COPD.”
LAMA/LABA inhalers decrease the risk of pneumonia by 33% to 67%, according to the analysis. 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.
“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.