Beyond lung function in COPD management: effectiveness of LABA/LAMA combination therapy on patient-centred outcomes.

Abstract

Bronchodilators are central to the management of chronic obstructive pulmonary disease (COPD). Clinical studies combining different classes of bronchodilators, in particular a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA), have demonstrated greater improvements in lung function (forced expiratory volume in 1 second, FEV1) in patients with COPD than monotherapy. FEV1 has served as an important diagnostic measurement of COPD, and the majority of clinical studies of currently available pharmacotherapies grade effectiveness of treatment regimens based on improvements in FEV1. However, FEV1 alone may not adequately reflect the overall health status of the patient. Published evidence suggests that LABA/LAMA combination therapies demonstrate greater improvements in patient-centred outcomes such as dyspnoea, symptoms, rescue medication use, and quality of life than individual drugs used alone. Evaluating patient-centred outcomes associated with COPD is likely to play an important role in future research as a measure of overall treatment effectiveness. Raising awareness of the importance of outcomes beyond lung function alone, particularly in primary care where most patients initially present themselves for medical evaluation, should form a fundamental part of a more holistic approach to COPD management.

• Authors: Thys van der Molen, Mario Cazzola
• Journal: Primary care respiratory journal : journal of the General Practice Airways Group (Prim Care Respir J) Vol. 21 Issue 1 Pg. 101-8 (Mar 2012) ISSN: 1475-1534 [Electronic] England
• PMID: 22222945 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Adrenergic beta-2 Receptor Agonists
• Bronchodilator Agents
• Muscarinic Antagonists

Topics

• Adrenergic beta-2 Receptor Agonists (therapeutic use)
• Bronchodilator Agents (therapeutic use)
• Drug Therapy, Combination
• Dyspnea (drug therapy)
• Humans
• Muscarinic Antagonists (therapeutic use)
• Pulmonary Disease, Chronic Obstructive (drug therapy)
• Quality of Life
• Treatment Outcome