Beyond lung function in COPD management: effectiveness of  LABA/LAMA combination therapy on patient-centred outcomes.
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.
Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands. t.van.der.molen@med.umcg.nl
Thys
T
van der Molen
Mario
M
Cazzola
D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004417:Dyspnea / Q000188:drug therapy; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D011788:Quality of Life; D016896:Treatment Outcome
D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D018727:Muscarinic Antagonists