Efficacy and safety of the dual bronchodilator combination umeclidinium/vilanterol in COPD by age and airflow limitation severity: A pooled post hoc analysis of seven clinical trials.
Administration, Inhalation
Adult
Aged
Aged, 80 and over
Benzyl Alcohols
/ therapeutic use
Bronchodilator Agents
/ administration & dosage
Chlorobenzenes
/ therapeutic use
Drug Combinations
Female
Fluticasone-Salmeterol Drug Combination
/ therapeutic use
Forced Expiratory Volume
/ drug effects
Humans
Lung
/ physiopathology
Male
Middle Aged
Muscarinic Antagonists
/ therapeutic use
Pulmonary Disease, Chronic Obstructive
/ drug therapy
Quinuclidines
/ therapeutic use
Tiotropium Bromide
/ therapeutic use
Treatment Outcome
(Max. 6): COPD
Dry powder inhaler
Elderly
GOLD stage
LAMA/LABA
Umeclidinium/vilanterol
Journal
Pulmonary pharmacology & therapeutics
ISSN: 1522-9629
Titre abrégé: Pulm Pharmacol Ther
Pays: England
ID NLM: 9715279
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
11
01
2019
revised:
01
05
2019
accepted:
08
05
2019
pubmed:
17
5
2019
medline:
16
4
2020
entrez:
17
5
2019
Statut:
ppublish
Résumé
Elderly patients with chronic obstructive pulmonary disease (COPD) and those with more severe airway limitation are perceived to experience reduced efficacy from inhaled bronchodilators, especially those administered in a dry powder inhaler. This study compared the efficacy and safety of a long-acting muscarinic antagonist/long-acting β This post hoc pooled analysis of seven randomized studies of ≥12 weeks' duration investigated the efficacy and safety of umeclidinium/vilanterol (UMEC/VI) 62.5/25 μg versus tiotropium (TIO) 18 μg or fluticasone propionate/salmeterol (FP/SAL) 250/50 μg. Change from baseline in trough forced expiratory volume in 1 s (FEV The pooled intent-to-treat population comprised 3821 patients (≥65 years: 44-45%; ≥75 years: 9-10%; GOLD stage 3/4: 50-55%); 2246, 874, and 701 patients received UMEC/VI, TIO, or FP/SAL, respectively. Significant improvements in trough FEV UMEC/VI consistently demonstrated improved lung function versus TIO and FP/SAL across age and airflow limitation severity subgroups, with no safety concerns, indicating that UMEC/VI provides no loss in efficacy or additional safety concerns for both elderly patients with COPD and patients with severe/very severe airway limitation.
Sections du résumé
BACKGROUND
Elderly patients with chronic obstructive pulmonary disease (COPD) and those with more severe airway limitation are perceived to experience reduced efficacy from inhaled bronchodilators, especially those administered in a dry powder inhaler. This study compared the efficacy and safety of a long-acting muscarinic antagonist/long-acting β
METHODS
This post hoc pooled analysis of seven randomized studies of ≥12 weeks' duration investigated the efficacy and safety of umeclidinium/vilanterol (UMEC/VI) 62.5/25 μg versus tiotropium (TIO) 18 μg or fluticasone propionate/salmeterol (FP/SAL) 250/50 μg. Change from baseline in trough forced expiratory volume in 1 s (FEV
RESULTS
The pooled intent-to-treat population comprised 3821 patients (≥65 years: 44-45%; ≥75 years: 9-10%; GOLD stage 3/4: 50-55%); 2246, 874, and 701 patients received UMEC/VI, TIO, or FP/SAL, respectively. Significant improvements in trough FEV
CONCLUSION
UMEC/VI consistently demonstrated improved lung function versus TIO and FP/SAL across age and airflow limitation severity subgroups, with no safety concerns, indicating that UMEC/VI provides no loss in efficacy or additional safety concerns for both elderly patients with COPD and patients with severe/very severe airway limitation.
Identifiants
pubmed: 31096036
pii: S1094-5539(19)30015-X
doi: 10.1016/j.pupt.2019.101802
pii:
doi:
Substances chimiques
Benzyl Alcohols
0
Bronchodilator Agents
0
Chlorobenzenes
0
Drug Combinations
0
Fluticasone-Salmeterol Drug Combination
0
GSK573719
0
Muscarinic Antagonists
0
Quinuclidines
0
vilanterol
028LZY775B
Tiotropium Bromide
XX112XZP0J
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
101802Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.