New combination bronchodilators for chronic obstructive pulmonary disease: current evidence and future perspectives.

摘要: Fixed dose combination (FDC) dual bronchodilators that co-administer a long acting β2-adrenoceptor agonist (LABA) and muscarinic antagonist (LAMA) are new class of inhaled treatment for chronic obstructive pulmonary disease (COPD). This review focuses on the clinical evidence benefit LABA/LAMA FDCs compared with monocomponent treatments, also active comparators widely used COPD, namely tiotropium salmeterol-fluticasone. Novel FDC include QVA149 umeclidinium/vilanterol (UMEC/VI). Long term trials show UMEC/VI superior to therapy in terms trough forced expiratory volume 1 s (FEV1), although FEV1 improvement was limited approximately 80–90% added values. suggests effect combining LABA LAMA is not fully additive. were associated largest mean changes symptoms health status above minimal clinically important difference, contrast monocomponents. Furthermore, these demonstrated superiority over salmeterol-fluticasone patient-reported outcomes. offer simplified means maximizing bronchodilation COPD patients, improvements lung function being mirrored by benefits exacerbations. The use practice set grow further studies needed define their optimal place guidelines.