Efficacy of umeclidinium/vilanterol according to the degree of reversibility of airflow limitation at screening: a post hoc analysis of the EMAX trial.
Adrenergic beta-2 Receptor Agonists
/ administration & dosage
Aged
Benzyl Alcohols
/ administration & dosage
Bronchodilator Agents
/ administration & dosage
Chlorobenzenes
/ administration & dosage
Double-Blind Method
Drug Combinations
Female
Forced Expiratory Volume
Humans
Lung
/ drug effects
Male
Middle Aged
Muscarinic Antagonists
/ administration & dosage
Pulmonary Disease, Chronic Obstructive
/ diagnosis
Quinuclidines
/ administration & dosage
Recovery of Function
Time Factors
Treatment Outcome
Bronchodilator reversibility
COPD
Dual bronchodilators
E-RS
Lung function
Rescue medication
SAC-TDI
Umeclidinium/vilanterol
Journal
Respiratory research
ISSN: 1465-993X
Titre abrégé: Respir Res
Pays: England
ID NLM: 101090633
Informations de publication
Date de publication:
28 Oct 2021
28 Oct 2021
Historique:
received:
13
05
2021
accepted:
08
10
2021
entrez:
29
10
2021
pubmed:
30
10
2021
medline:
8
2
2022
Statut:
epublish
Résumé
In patients with chronic obstructive pulmonary disease (COPD), the relationship between short-term bronchodilator reversibility and longer-term response to bronchodilators is unclear. Here, we investigated whether the efficacy of long-acting bronchodilators is associated with reversibility of airflow limitation in patients with COPD with a low exacerbation risk not receiving inhaled corticosteroids. The double-blind, double-dummy EMAX trial randomised patients to umeclidinium/vilanterol 62.5/25 µg once daily, umeclidinium 62.5 µg once daily, or salmeterol 50 µg twice daily. Bronchodilator reversibility to salbutamol was measured once at screening and defined as an increase in forced expiratory volume in 1 s (FEV The mean (standard deviation) reversibility was 130 mL (156) and the median was 113 mL; 625/2425 (26%) patients were reversible. There was a trend towards greater improvements in trough FEV FP analyses suggest that patients with higher levels of reversibility have greater improvements in lung function and symptoms in response to bronchodilators. Improvements in lung function and rescue medication use were greater with umeclidinium/vilanterol versus monotherapy across the full range of reversibility, suggesting that the dual bronchodilator umeclidinium/vilanterol may be an appropriate treatment for patients with symptomatic COPD, regardless of their level of reversibility.
Sections du résumé
BACKGROUND
BACKGROUND
In patients with chronic obstructive pulmonary disease (COPD), the relationship between short-term bronchodilator reversibility and longer-term response to bronchodilators is unclear. Here, we investigated whether the efficacy of long-acting bronchodilators is associated with reversibility of airflow limitation in patients with COPD with a low exacerbation risk not receiving inhaled corticosteroids.
METHODS
METHODS
The double-blind, double-dummy EMAX trial randomised patients to umeclidinium/vilanterol 62.5/25 µg once daily, umeclidinium 62.5 µg once daily, or salmeterol 50 µg twice daily. Bronchodilator reversibility to salbutamol was measured once at screening and defined as an increase in forced expiratory volume in 1 s (FEV
RESULTS
RESULTS
The mean (standard deviation) reversibility was 130 mL (156) and the median was 113 mL; 625/2425 (26%) patients were reversible. There was a trend towards greater improvements in trough FEV
CONCLUSIONS
CONCLUSIONS
FP analyses suggest that patients with higher levels of reversibility have greater improvements in lung function and symptoms in response to bronchodilators. Improvements in lung function and rescue medication use were greater with umeclidinium/vilanterol versus monotherapy across the full range of reversibility, suggesting that the dual bronchodilator umeclidinium/vilanterol may be an appropriate treatment for patients with symptomatic COPD, regardless of their level of reversibility.
Identifiants
pubmed: 34711232
doi: 10.1186/s12931-021-01859-w
pii: 10.1186/s12931-021-01859-w
pmc: PMC8555352
doi:
Substances chimiques
Adrenergic beta-2 Receptor Agonists
0
Benzyl Alcohols
0
Bronchodilator Agents
0
Chlorobenzenes
0
Drug Combinations
0
GSK573719
0
Muscarinic Antagonists
0
Quinuclidines
0
vilanterol
028LZY775B
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
279Subventions
Organisme : GSK
ID : 201749 [NCT03034915]
Informations de copyright
© 2021. The Author(s).
Références
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