Drug Combination Better than LABAs Alone for COPD

Chronic obstructive pulmonary disease (COPD) is a manageable respiratory condition, but it is also the third-leading cause of death in the United States. To get the best outcome, it’s helpful to know which prescription medications are most effective.

Long-acting beta-agonists (LABAs) are medications that relax the muscles around the airways, letting a patient breathe more easily. Inhaled corticosteroids help treat inflammation in the airways, and only small amounts of the medicine are absorbed into the body.

Now, a new study shows that newly prescribed LABAs and an inhaled corticosteroid combination therapy work better in older adults with COPD than newly prescribed LABAs alone.

COPD combination therapy was linked to a significantly lower risk of COPD hospitalization and death, according to the study, published in the Journal of the American Medical Association. Combination therapy was also tied to better results for people with asthma.

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LABAs Versus Combination Therapy

Researchers led by Dr. Andrea S. Gershon of the Sunnybrook Health Sciences Center and Institute for Clinical Evaluative Sciences in Toronto, Canada compared combination therapy to treatment with just LABAs in older people who had COPD and other breathing illnesses such as asthma.

The study included all Ontario residents ages 66 and older who had COPD and were new users of LABAs or a LABA combination therapy from September 2003 to March 2011. There were 3,160 users of just LABAs and 8,712 new users of LABAs and inhaled corticosteroids. They were followed for an average of 2.5 years and 2.7 years, respectively.

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Findings Pave the Way for New Treatment Guidelines

LABAs and inhaled corticosteroids together were associated with a lower risk of death or hospitalization than LABAs alone.

Of the 5,594 new users of LABAs and inhaled corticosteroids, 36.4 percent died and 27.8 percent were hospitalized during the study period. Meanwhile, among new users of just LABAs, 37.3 percent died and 30.1 percent were hospitalized.

“For people with COPD, these study findings might lead to a change in their medication, depending on their circumstances,” Gershon told Healthline. “Time will tell if they pave the path for treatment guidelines, but I believe they have the potential to do so.”

Those who had COPD and asthma and those who weren’t also taking an inhaled long-acting anticholinergic medication for COPD were at the greatest disadvantage if they were prescribed LABAs alone. Anticholinergics are a class of drugs that block the action of the neurotransmitter chemical acetylcholine in the brain.

Gershon told Healthline that these findings should be confirmed in randomized clinical trials before being applied to patient care.

“However, until that is done, they offer important new knowledge that physicians can use to determine the best care for their patients,” Gershon said.

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