LABA/LAMA as First-Line Therapy for COPD: A Summary of the Evidence and Guideline Recommendations
Abstract
:1. Introduction
2. Global and National COPD Treatment Guidelines
3. Evidence for the Effectiveness and Safety of LABA/LAMA versus Other Therapies
3.1. Evidence for the Benefits of LABA/LAMA versus Monotherapies
3.2. Evidence for the Benefits of LABA/LAMA versus LABA/ICS
3.3. Comparison of LABA/LAMA versus Triple Therapy
4. Summary of Recommendations for the Use of LABA/LAMA
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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LABA/LAMA | Device | Approved Dose | Frequency of Administration |
---|---|---|---|
Tiotropium/olodaterol | Respimat® | 2.5/2.5 µg * | Once daily |
Aclidinium/formoterol | Genuair® | 340/12 µg † | Twice daily |
400/12 µg ‡ | Twice daily | ||
Umeclidinium/vilanterol | Ellipta® | 55/22 µg § | Once daily |
62.5/25 µg ‖ | Once daily | ||
Glycopyrronium/indacaterol | Breezhaler® | 85/43 µg ¶ | Once daily |
Neohaler® | 27.5/15.6 µg ** | Twice daily | |
Glycopyrronium/formoterol fumarate | Aerosphere® | 7.2/5 μg †† | Twice daily |
9/4.8 μg ‡‡ | Twice daily |
Guideline | Dyspnea, Infrequent Exacerbations | Dyspnea, Frequent Exacerbations |
---|---|---|
GOLD [1] | Initial treatment
| Initial treatment
|
ATS [13] |
|
|
NICE [18] |
|
|
Spain [19,30] |
|
|
Germany [20] |
|
|
Japan [21,31] |
|
|
Latin America (ALAT) [32] |
|
|
Czech Republic [23] |
|
|
Canada [24] |
|
|
Australia and New Zealand (TSANZ) [33] |
|
|
LABA/LAMA versus | Lung Function | Dyspnea | Exacerbations | Exercise Tolerance | Health/ Functional Status/ Quality of Life | Pneumonia |
---|---|---|---|---|---|---|
LAMA | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rodrigo Int J Chron Obstruct Pulmon Dis 2017 SR/MA [38] |
Calzetta Eur Respir Rev 2017 MA [39] | Calzetta Eur Respir Rev 2017 MA [39] | Calverley Lancet Respir Med 2018 RCT [40] | Calzetta Respir Med 2017 MA [41] | Calzetta Eur Respir Rev 2017 MA [39] | Oba Cochrane Library 2018 SR/MA [34] | |
Aziz Int J Chron Obstruct Pulmon Dis 2018 SR/MA [42] | Mahler Eur Respir J 2014 RCT [43] | Ichinose Int J Chron Obstruct Pulmon Dis 2018 RCT [44] | O’Donnell Eur Respir J 2017 PRCT [45] | Ferguson NPJ Prim Care Respir Med 2017 PRCT [46] | ||
Mahler Eur Respir J 2014 RCT [43] | Ferguson NPJ Prim Care Respir Med 2017 PRCT [46] | Wedzicha Adv Ther 2020 PRCT [47] | Minakata Int J Chron Obstruct Pulmon Dis 2019 PRCT [48] | Martinez Int J Chron Obstruct Pulmon Dis 2019 PRCT [49] | ||
Martinez Int J Chron Obstruct Pulmon Dis 2019 PRCT [49] | Martinez Int J Chron Obstruct Pulmon Dis 2019 PRCT [49] | Chen Ther Adv Respir Dis 2020 SR/MA [35] | Ichinose Int J Chron Obstruct Pulmon Dis 2018 RCT [50] | Price Int J Chron Obstruct Pulmon Dis 2017 SR [51] | ||
Price Int J Chron Obstruct Pulmon Dis 2017 SR [51] | Price Int J Chron Obstruct Pulmon Dis 2017 SR [51] | Mammen et al. Ann Am Thorac Soc 2020 aSR/MA [36] | Maltais Adv Ther 2021 MA/PRCT [52] | Buhl Eur Respir J 2015 PRCT [53] | ||
Buhl Eur Respir J 2015 PRCT [53] | O’Donnell Eur Respir J 2017 PRCT [45] | Takahashi Int J Chron Obstruct Pulmon Dis 2020 RCT [54] | Singh Respir Med 2015 PRCT [55] | |||
Singh Respir Med 2015 PRCT [55] | Miravitlles Respir Res 2017 SR/MA [56] | Labor Respiration 2018 SR [57] | ||||
Beeh Pulm Pharmacol Ther 2015 RCT [58] | Rodrigo Int J Chron Obstruct Pulmon Dis 2017 SR/MA [38] | Miravitlles Respir Res 2017 SR/MA [56] | ||||
Maltais Adv Ther 2019 RCT [59] | Takahashi Int J Chron Obstruct Pulmon Dis 2020 RCT [54] | Rodrigo Int J Chron Obstruct Pulmon Dis 2017 SR/MA [38] | ||||
Miravitlles Respir Res 2017 SR/MA [56] | Calzetta Chest 2016 SR/MA [60] | Calzetta Chest 2016 SR/MA [60] | ||||
Rodrigo Int J Chron Obstruct Pulmon Dis 2017 SR/MA [38] | Mammen et al. Ann Am Thorac Soc 2020 aSR/MA [36] | Mammen et al. Ann Am Thorac Soc 2020 aSR/MA [36] | ||||
Calzetta Chest 2016 SR/MA [60] | Maltais Eur Respir J 2019 RCT [61] | |||||
O’Donnell Eur Resp J 2017 PRCT [45] | ||||||
Ichinose Int J Chron Obstruct Pulmon Dis 2018 RCT2 [50] | ||||||
Maltais Adv Ther 2021 MA/PRCT [52] | ||||||
Takahashi Int J Chron Obstruct Pulmon Dis 2020 RCT [54] | ||||||
LABA | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Oba Cochrane Library 2018 SR/MA [34] |
Calzetta Eur Respir Rev 2017 MA [39] | Calzetta Eur Respir Rev 2017 MA [39] | Mammen et al. Ann Am Thorac Soc 2020 aSR/MA [36] | O’Donnell Eur Respir J 2017 PRCT [45] | Calzetta Eur Respir Rev 2017 MA [39] | ||
Price Int J Chron Obstruct Pulmon Dis 2017 SR [51] | Ferguson NPJ Prim Care Respir Med 2017 PRCT [46] | Ferguson NPJ Prim Care Respir Med 2017 PRCT [46] | ||||
Beeh Pulm Pharmacol Ther 2015 RCT [58] | Price Int J Chron Obstruct Pulmon Dis 2017 SR [51] | Price Int J Chron Obstruct Pulmon Dis 2017 SR [51] | ||||
Miravitlles Respir Res 2017 SR/MA [56] | Miravitlles Respir Res 2017 SR/MA [56] | Miravitlles Respir Res 2017 SR/MA [56] | ||||
Calzetta Chest 2016 SR/MA [60] | Calzetta Chest 2016 SR/MA [60] | Calzetta Chest 2016 SR/MA [60] | ||||
O’Donnell Eur Respir J 2017 PRCT [45] | O’Donnell Eur Respir J 2017 PRCT [45] | Labor Respiration 2018 SR [57] | ||||
Mammen et al. Ann Am Thorac Soc 2020 aSR/MA [36] | Mammen et al. Ann Am Thorac Soc 2020 aSR/MA [36] | |||||
LABA/ICS | Horita Cochrane Database Syst Rev 2017 CR [62] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Horita Cochrane Database Syst Rev 2017 CR [62] | Horita Cochrane Database Syst Rev 2017 CR [62] | Suissa Chest 2019 RWS [63] | |
Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Miravitlles Respir Res 2017 SR/MA [56] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Rogliani Int J Chron Obstruct Pulmon Dis 2018 SR [37] | Quint Adv Ther 2021 RWS [64] | ||
Aziz Int J Chron Obstruct Pulmon Dis 2018 SR/MA [42] | Rodrigo Int J Chron Obstruct Pulmon Dis 2017 SR/MA [38] | Rodrigo Int J Chron Obstruct Pulmon Dis 2017 SR/MA [38] | Miravitlles Respir Res 2017 SR/MA [56] | Horita Cochrane Database Syst Rev 2017 CR [62] | ||
Beeh Int J Chron Obstruct Pulmon Dis 2016 RCT [65] | Quint Adv Ther 2021 RWS [64] | Rodrigo Int J Chron Obstruct Pulmon Dis 2017 SR/MA [38] | Rodrigo Int J Chron Obstruct Pulmon Dis 2017 SR/MA [38] | |||
Miravitlles Respir Res 2017 SR/MA [56] | Suissa Chest 2019 RWS [63] | |||||
Rodrigo Int J Chron Obstruct Pulmon Dis 2017 SR/MA [38] | ||||||
Triple therapy | Cazzola Eur Respir J 2018 SR/MA [66] | Koarai Respir Res 2021 SR/MA [67] | Cazzola Eur Respir J 2018 SR/MA [66] | Koarai Respir Res 2021 SR/MA [67] | Mammen Annals ATS 2020 bSR/MA [68] | |
Koarai Respir Res 2021 SR/MA [67] | Mammen Annals ATS 2020 bSR/MA [68] | Koarai Respir Res 2021 SR/MA [67] | Koarai Respir Investig 2022 SR/MA [69] | Zheng The BMJ 2018 SR/MA [70] | ||
Koarai Respir Investig 2022 SR/MA [69] | Cabrera Ann Epidemiol 2022 RWS [71] | Zheng The BMJ 2018 SR/MA [70] | Quint Expert Rev Respir Med 2022 RWS [72] | |||
Zheng The BMJ 2018 SR/MA [70] | Quint Expert Rev Respir Med 2022 RWS [72] | Koarai Respir Res 2021 SR/MA [67] | ||||
Suissa Chest 2020 RWS [73] | Suissa Chest 2020 RWS [73] | |||||
Koarai Respir Investig 2022 SR/MA [69] | Cazzola Eur Respir J 2018 SR/MA [66] | |||||
Lee PLOS Med 2019 SR/MA [74] | Koarai Respir Investig 2022 SR/MA [69] | |||||
Mammen Annals ATS 2020 bSR/MA [68] | Lee PLOS Med 2019 SR/MA [74] | |||||
Zheng The BMJ 2018 SR/MA [70] |
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Miravitlles, M.; Kawayama, T.; Dreher, M. LABA/LAMA as First-Line Therapy for COPD: A Summary of the Evidence and Guideline Recommendations. J. Clin. Med. 2022, 11, 6623. https://doi.org/10.3390/jcm11226623
Miravitlles M, Kawayama T, Dreher M. LABA/LAMA as First-Line Therapy for COPD: A Summary of the Evidence and Guideline Recommendations. Journal of Clinical Medicine. 2022; 11(22):6623. https://doi.org/10.3390/jcm11226623
Chicago/Turabian StyleMiravitlles, Marc, Tomotaka Kawayama, and Michael Dreher. 2022. "LABA/LAMA as First-Line Therapy for COPD: A Summary of the Evidence and Guideline Recommendations" Journal of Clinical Medicine 11, no. 22: 6623. https://doi.org/10.3390/jcm11226623