How can the findings of the EMAX trial on long-acting bronchodilation in chronic obstructive pulmonary disease be applied in the primary care setting?
(2023) In Chronic Respiratory Disease 20.- Abstract
This review addresses outstanding questions regarding initial pharmacological management of chronic obstructive pulmonary disease (COPD). Optimizing initial treatment improves clinical outcomes in symptomatic patients, including those with low exacerbation risk. Long-acting muscarinic antagonist/long-acting β2-agonist (LAMA/LABA) dual therapy improves lung function versus LAMA or LABA monotherapy, although other treatment benefits have been less consistently observed. The benefits of dual bronchodilation in symptomatic patients with COPD at low exacerbation risk, and its duration of efficacy and cost effectiveness in this population, are not yet fully established. Questions remain on the impact of baseline symptom severity,... (More)
This review addresses outstanding questions regarding initial pharmacological management of chronic obstructive pulmonary disease (COPD). Optimizing initial treatment improves clinical outcomes in symptomatic patients, including those with low exacerbation risk. Long-acting muscarinic antagonist/long-acting β2-agonist (LAMA/LABA) dual therapy improves lung function versus LAMA or LABA monotherapy, although other treatment benefits have been less consistently observed. The benefits of dual bronchodilation in symptomatic patients with COPD at low exacerbation risk, and its duration of efficacy and cost effectiveness in this population, are not yet fully established. Questions remain on the impact of baseline symptom severity, prior treatment, degree of reversibility to bronchodilators, and smoking status on responses to dual bronchodilator treatment. Using evidence from EMAX (NCT03034915), a 6-month trial comparing the LAMA/LABA combination umeclidinium/vilanterol with umeclidinium and salmeterol monotherapy in symptomatic patients with COPD at low exacerbation risk who were inhaled corticosteroid-naïve, we describe how these findings can be applied in primary care.
(Less)
- author
- Kerwin, Edward M. ; Jones, Paul W. ; Bjermer, Leif H. LU ; Maltais, François ; Boucot, Isabelle H. ; Naya, Ian P. ; Lipson, David A. ; Compton, Chris ; Tombs, Lee and Vogelmeier, Claus F.
- organization
- publishing date
- 2023-01-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- initial maintenance therapy, long-acting bronchodilators, long-acting muscarinic antagonist/long-acting β-agonist dual therapy, primary care, Symptomatic chronic obstructive pulmonary disease
- in
- Chronic Respiratory Disease
- volume
- 20
- publisher
- SAGE Publications
- external identifiers
-
- pmid:37800633
- scopus:85173320675
- ISSN
- 1479-9723
- DOI
- 10.1177/14799731231202257
- language
- English
- LU publication?
- yes
- id
- 00656abb-9351-4ddd-817e-c84d441dbc2f
- date added to LUP
- 2023-12-19 14:22:37
- date last changed
- 2025-01-24 05:23:45
@article{00656abb-9351-4ddd-817e-c84d441dbc2f,
abstract = {{<p>This review addresses outstanding questions regarding initial pharmacological management of chronic obstructive pulmonary disease (COPD). Optimizing initial treatment improves clinical outcomes in symptomatic patients, including those with low exacerbation risk. Long-acting muscarinic antagonist/long-acting β<sub>2</sub>-agonist (LAMA/LABA) dual therapy improves lung function versus LAMA or LABA monotherapy, although other treatment benefits have been less consistently observed. The benefits of dual bronchodilation in symptomatic patients with COPD at low exacerbation risk, and its duration of efficacy and cost effectiveness in this population, are not yet fully established. Questions remain on the impact of baseline symptom severity, prior treatment, degree of reversibility to bronchodilators, and smoking status on responses to dual bronchodilator treatment. Using evidence from EMAX (NCT03034915), a 6-month trial comparing the LAMA/LABA combination umeclidinium/vilanterol with umeclidinium and salmeterol monotherapy in symptomatic patients with COPD at low exacerbation risk who were inhaled corticosteroid-naïve, we describe how these findings can be applied in primary care.</p>}},
author = {{Kerwin, Edward M. and Jones, Paul W. and Bjermer, Leif H. and Maltais, François and Boucot, Isabelle H. and Naya, Ian P. and Lipson, David A. and Compton, Chris and Tombs, Lee and Vogelmeier, Claus F.}},
issn = {{1479-9723}},
keywords = {{initial maintenance therapy; long-acting bronchodilators; long-acting muscarinic antagonist/long-acting β-agonist dual therapy; primary care; Symptomatic chronic obstructive pulmonary disease}},
language = {{eng}},
month = {{01}},
publisher = {{SAGE Publications}},
series = {{Chronic Respiratory Disease}},
title = {{How can the findings of the EMAX trial on long-acting bronchodilation in chronic obstructive pulmonary disease be applied in the primary care setting?}},
url = {{http://dx.doi.org/10.1177/14799731231202257}},
doi = {{10.1177/14799731231202257}},
volume = {{20}},
year = {{2023}},
}