title: Recent advances in COPD disease management with fixed-dose long-acting combination therapies.
abstract: Combinations of two long-acting bronchodilators and long-acting bronchodilators with inhaled corticosteroids (ICS) are recommended therapies in the management of chronic obstructive pulmonary disease (COPD). Three fixed-dose combination products have recently been approved for the treatment of COPD (the long-acting β2-agonist plus long-acting muscarinic antagonist [LABA/LAMA] combinations glycopyrronium/indacaterol [QVA149] and umeclidinium/vilanterol, and the LABA/ICS fluticasone furoate/vilanterol), with others currently in late-stage development. LABA/LAMA and LABA/ICS combination therapies demonstrate positive effects on both lung function and patient-reported outcomes, with significant improvements observed with LABA/LAMA combinations compared with placebo, each component alone and other comparators in current use. No new safety concerns have been observed with combinations of long-acting bronchodilators. Combinations of two long-acting bronchodilators represent a new and convenient treatment option in COPD. This review summarizes published efficacy and safety data from clinical trials of both LABA/LAMA and novel LABA/ICS combinations in patients with COPD.
authors.affiliation: Department of Medicine, Division of Pulmonology, University of Cape Town, George Street, Mowbray 7700, Cape Town, South Africa.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Bateman
authors.forename: Donald A
authors.initials: DA
authors.lastname: Mahler
authors.forename: Claus F
authors.initials: CF
authors.lastname: Vogelmeier
authors.forename: Jadwiga A
authors.initials: JA
authors.lastname: Wedzicha
authors.forename: Francesco
authors.initials: F
authors.lastname: Patalano
authors.forename: Donald
authors.initials: D
authors.lastname: Banerji
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives; D001592:Benzyl Alcohols / Q000008:administration & dosage; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002722:Chlorobenzenes / Q000008:administration & dosage; D019468:Disease Management; D018450:Disease Progression; D004338:Drug Combinations; D004983:Ethanolamines / Q000008:administration & dosage; D000068759:Formoterol Fumarate; D006024:Glycopyrrolate / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007189:Indans / Q000008:administration & dosage; D018727:Muscarinic Antagonists / Q000008:administration & dosage*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D015363:Quinolones / Q000008:administration & dosage; D011812:Quinuclidines / Q000008:administration & dosage; D000068299:Salmeterol Xinafoate; D012602:Scopolamine Derivatives / Q000008:administration & dosage; D000069447:Tiotropium Bromide; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D001592:Benzyl Alcohols; D001993:Bronchodilator Agents; D002722:Chlorobenzenes; D004338:Drug Combinations; D004983:Ethanolamines; C573971:GSK573719; D007189:Indans; D018727:Muscarinic Antagonists; D015363:Quinolones; D011812:Quinuclidines; D012602:Scopolamine Derivatives; C554862:indacaterol-glycopyrronium combination; C550468:vilanterol; D000068299:Salmeterol Xinafoate; C510790:indacaterol; D000420:Albuterol; D006024:Glycopyrrolate; D000068759:Formoterol Fumarate; D000069447:Tiotropium Bromide
keywords: chronic obstructive pulmonary disease; combination therapy; exacerbation; inhaled corticosteroids; long-acting bronchodilators; lung function; patient-reported outcomes