LABA Plus LAMA Therapy Associated With Fewer Exacerbations in COPD

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Incidence of all-cause mortality or severe adverse events did not differ between the COPD treatment groups.
Incidence of all-cause mortality or severe adverse events did not differ between the COPD treatment groups.

HealthDay News — Treatment with long-acting muscarinic antagonists (LAMA) plus long-acting beta-agonists (LABA) is associated with fewer exacerbation events in patients with chronic obstructive pulmonary disease (COPD), according to a clinical evidence synopsis published online in the Journal of the American Medical Association.

Nobuyuki Horita, MD, PhD, from Yokohama City University Graduate School of Medicine in Japan, and colleagues summarized a Cochrane review that assessed inhaled LAMA, LABA, and inhaled corticosteroids (ICS) for the treatment of stable COPD. The clinical synopsis discusses the appropriate combinations.

The researchers found that compared with LABA plus ICS, treatment with LAMA plus LABA is associated with fewer exacerbation events in patients with COPD and greater improvement forced expiratory volume in the first second of expiration, measured in the morning before the first dose of medication. There were no differences in the incidence of severe adverse events or all-cause mortality between the groups. 

The findings are aligned with the GOLD 2017 guidelines, which recommended LAMA plus LABA as the second choice after single bronchodilator therapies for more symptomatic patients with low risk for COPD exacerbation events and less symptomatic patients with frequent exacerbation events.

"Longer-term follow-up data would be beneficial, especially to identify the effects of specific therapies on serious adverse events and mortality," the researchers wrote.

Disclosures: One author disclosed financial ties to the pharmaceutical industry.

Reference

Horita N, Nagashima A, Kaneko T. Long-acting beta-agonists (LABA) combined with long-acting muscarinic antagonists or LABA combined with inhaled corticosteroids for patients with stable COPD. JAMA. 2017;318(13):1274-1275. doi:10.1001/jama.2017.11903

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