#Lama laba copd update

Dual bronchodilator therapy also is an initial treatment option for group D patients who are highly symptomatic (COPD Assessment Test score > 20), and a combination of a LABA and inhaled corticosteroid (ICS) is an initial treatment option for group D patients with a blood eosinophil count of 300 cells/μL or more. Alternatively, long-acting β 2-agonist (LABA) monotherapy can be used as initial treatment for GOLD group B, and dual bronchodilator therapy with a LABA/LAMA combination may be considered for group B patients with severe breathlessness. Long-acting muscarinic antagonist (LAMA) monotherapy is recommended as initial treatment for GOLD groups B, C, and D. A separate follow-up treatment algorithm is provided that is based on the predominant treatable trait (dyspnea or exacerbations) and current treatment, and is independent of ABCD group at initiation of treatment. After initial treatment, the GOLD committee recommends regular review of symptoms assessment of inhaler technique and adherence, as well as non-pharmacological approaches and treatment adjustment as needed.

#Lama laba copd update

The 2020 update of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy document includes a model for initiation of pharmacological treatment, which is based on assessment of symptoms and exacerbation risk according to the ABCD assessment tool. In addition, high inspiratory flow rates are not required.īronchodilators are the mainstay of pharmacological treatment in chronic obstructive pulmonary disease (COPD). The SMI generates a low-velocity, long-duration aerosol spray with a high fine-particle fraction, which results in marked lung drug deposition. Tiotropium is safe and efficacious as a long-term, once-daily LAMA for the maintenance treatment of COPD and for reducing COPD exacerbations. In this review, we provide an overview of studies of tiotropium for the treatment of COPD, with a focus on pivotal studies. These positive efficacy findings triggered the evaluation of tiotropium in fixed-dose combination with olodaterol (a long-acting β 2-agonist). Results of short- and long-term randomized, controlled clinical trials of tiotropium in patients with COPD indicated tiotropium was safe and significantly improved lung function, health-related quality of life, and exercise endurance, and reduced dyspnea, lung hyperinflation, exacerbations, and use of rescue medication compared with placebo or active comparators. The SMI was designed to overcome or minimize some of the issues associated with other inhaler types (eg, the need for strong inspiratory airflow with DPIs). Later, tiotropium also became available as an inhalation spray delivered via a soft mist inhaler (SMI). Tiotropium was initially available as an inhalation powder delivered via a dry-powder inhaler (DPI). Tiotropium bromide was the first LAMA available for COPD in clinical practice and, because of its long duration of action, is administered once daily. Bronchodilators are the mainstay of pharmacological treatment in chronic obstructive pulmonary disease (COPD), and long-acting muscarinic antagonist (LAMA) monotherapy is recommended as initial treatment for Global Initiative for Chronic Obstructive Lung Disease (GOLD) groups B, C, and D.