Combination of long-acting bronchodilators improves lung function for
patients with COPD
A combination of the long-acting bronchodilators tiotropium and formoterol
improves lung function in patients with chronic obstructive pulmonary
disease more than a bronchodilator/anti-inflammatory combination, according
to a study reported this week at the annual European Respiratory Society
congress in Copenagen.
The study randomised 592 patients with moderate COPD to a combination
of tiotropium (18µg once daily) plus formoterol (12µg twice
daily) or to salmeterol (50µg twice daily) plus fluticasone propionate
(500µg twice daily).
Results showed that peak expiratory volume in one second (FEV1) increased
by an average of 103ml more in the tiotropium plus formoterol group than
in those given salmeterol plus fluticasone (1.775L versus 1.672L, P<0.0001)
after six weeks’ treatment.
Hannah George, senior respiratory specialist pharmacist, Royal Liverpool
University Hospital NHS Trust, said: “These combinations are already
being used widely in practice and it is encouraging to see research is
ongoing to improve the evidence base in this area. It is logical to use
two different bronchodilators acting on different receptors and many
patients are currently obtaining benefit from these combinations.” She
added that counselling and education are important to ensure that patients
know what each inhaler is for and its benefits.
David Price, professor of primary care respiratory medicine at the University
of Aberdeen, added: “We need to be more aggressive in how we treat
COPD. Achieving maximal bronchodilation in earlier COPD is the key to
improving long-term outcomes.” A longer-term study — the
UPLIFT trial — is currently investigating whether 24-hour bronchodilation
with tiotropium improves COPD disease progression, including health related
quality of life and exacerbations. |
The
Pharmaceutical Journal
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