Optimizing bronchodilation in the prevention of COPD exacerbations

Página do item simplificado
dc.citation.volume18]
dc.contributor.authorMiravitlles, Marc
dc.contributor.authorAnzueto, Antonio
dc.contributor.authorJardim, Jose R. [UNIFESP]
dc.coverageLondon
dc.date.accessioned2020-06-26T16:30:35Z
dc.date.available2020-06-26T16:30:35Z
dc.date.issued2017
dc.description.abstractThe natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilizationen
dc.description.abstractreduced quality of lifeen
dc.description.abstractand increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations ( GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting beta(2)- agonist (LABA)/LAMA combination, respectively, as preferred initial treatments. The latter recommendation is based on recent trial evidence demonstrating the superior efficacy of a fixed-dose LABA/LAMA over an inhaled corticosteroid (ICS)/LABA in exacerbation prevention. ICS in combination with a LABA is also indicated for prevention of exacerbations, but the use of ICS is associated with an increased risk of adverse events such as pneumonia, and offers limited benefits beyond those provided by LABA or LAMA monotherapy. In this review, we examine evidence from a number of pivotal studies of LABAs and LAMAs, administered as monotherapy or as part of dual or triple combination therapy, with a specific focus on their effect on exacerbations. We also discuss a new proposed treatment paradigm for the management of COPD that takes into account this recent evidence and adopts a more cautious approach to the use of ICS. In alignment with GOLD 2017, we suggest that ICS should be reserved for patients with concomitant asthma or in whom exacerbations persist despite treatment with LABA/LAMA.en
dc.description.affiliationHosp Univ Vall dHebron, CIBER Enfermedades Resp CIBERES, Pneumol Dept, Barcelona, Spain
dc.description.affiliationUniv Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA
dc.description.affiliationSouth Texas Vet Hlth Care Syst, San Antonio, TX USA
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Resp Div, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Resp Div, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNovartis Pharma AG (Basel, Switzerland)
dc.description.sponsorshipIDNovartis Pharma AG (Basel, Switzerland)
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1186/s12931-017-0601-2]
dc.identifier.citationRespiratory Research. London, v. 18, p. -, 2017.
dc.identifier.doi10.1186/s12931-017-0601-2
dc.identifier.fileWOS000405877600001.pdf
dc.identifier.issn1465-993X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/53644
dc.identifier.wosWOS:000405877600001
dc.language.isoeng
dc.publisherBiomed Central Ltd
dc.relation.ispartofRespiratory Research
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectDual bronchodilationen
dc.subjectICSen
dc.subjectLABAen
dc.subjectLAMAen
dc.subjectTreatment guidelinesen
dc.subjectTriple therapyen
dc.titleOptimizing bronchodilation in the prevention of COPD exacerbationsen
dc.typeinfo:eu-repo/semantics/article
Arquivos
Pacote Original
Agora exibindo 1 - 1 de 1
Imagem de Miniatura
Nome:
WOS000405877600001.pdf
Tamanho:
852.16 KB
Formato:
Adobe Portable Document Format
Descrição:
Baixar
Coleções
EPM - Artigos