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. 2021 Jun 16;10(12):2649.
doi: 10.3390/jcm10122649.

Comparison of Effectiveness Using Different Dual Bronchodilator Agents in Chronic Obstructive Pulmonary Disease Treatment

Shih-Lung Cheng  1   2
Affiliations

Comparison of Effectiveness Using Different Dual Bronchodilator Agents in Chronic Obstructive Pulmonary Disease Treatment

Shih-Lung Cheng. J Clin Med. .

Abstract

The effectiveness and safety of fixed dual long-acting bronchodilators for chronic obstructive pulmonary disease (COPD) patients have been well established; however, there is a paucity of clinical effectiveness comparison in patients with COPD treatment. The aim of the current study was to compare the effectiveness of three once-daily dual bronchodilator agents in patients with COPD. Patients with diagnosed COPD and treated with a long-acting beta-agonist (LABA) + long-acting muscarinic antagonist (LAMA) fixed-dose combination therapy (UME/VIL (umeclidinium and vilanterol inhalation powder), IND/GLY (indacaterol and glycopyrronium), and TIO/OLO (tiotropium and olodaterol)) were enrolled in this retrospective study over a period of 12 months. Effectiveness assessments were evaluated using a COPD assessment test (CAT) and lung function parameters. Besides, times for acute exacerbation were also assessed. The enrolled patients' number was 177 in IND/GLY, 176 in UME/VIL and 183 in TIO/OLO. Lung function measurements with FEV1 had significantly improved for patients using TIO/OLO (98.7 mL) compared to those of IND/GLY (65.2 mL) and UME/VIL (64.4 mL) (p < 0.001). CAT scores were also significantly decreased in patients treated with TIO/OLO (CAT down 5.6) than those with IND/GLY (3.8) and UME/VIL (3.9) (p = 0.03). Acute exacerbation was also reduced in patients using TIO/OLO (4.9%) compared with those using IND/GLY (10.2%) and UME/VIL (11.9%) (p = 0.01). Significant improvement in pulmonary function, symptoms were demonstrated after 12 months of LABA/LAMA fixed-dose combination therapy with three different treatment options. TIO/OLO demonstrated higher therapeutic effects compared with UME/VIL or IND/GLY. Determining clinical relevance will require a well-designed randomized controlled trial.

Keywords: LABA/LAMA; chronic obstructive pulmonary disease (COPD); dual bronchodilator.

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Conflict of interest statement

The authors declare that they have no competing interests. The manuscript reports studies involving human participants, human data, and statement on ethics approval and consent is IBR Number: 107006-E, and the name of the ethics committee is Research Ethics Review Committee, Far Eastern Memorial Hospital.

Figures

Figure 1
Figure 1
FEV1 differences after 12 months of treatment by COPD medication. Note: Means are shown in the bar chart; p-values were generated using Tukey’s HSD (Honest Significant Difference) for comparisons between users of different medication, p < 0.05 was considered significant (p < 0.001).
Figure 2
Figure 2
FVC differences after 12 months of treatment by COPD medications. Note: Means are shown in the bar chart; p-values were generated using Tukey’s HSD (Honest Significant Difference) for comparisons between users of different medication, p < 0.05 was considered significant (p < 0.001).
Figure 3
Figure 3
CAT score differences after 12 months of treatment by COPD medications. Note: Means are shown in the bar chart; p-values were generated using Tukey’s HSD (Honest Significant Difference) for comparisons between users of different medication, p < 0.05 was considered significant (p < 0.001, p < 0.004).
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