Latest clinical trials advance COPD management



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– Recent studies have shown that the use of a long-acting beta2-agonist/long-acting muscarinic antagonist (LABA/LAMA) combination is superior to LAMA alone in endpoints including exacerbation, Nicola A. Hanania, MD, FCCP, said in a panel discussion session at the annual meeting of the American College of Chest Physicians.

Other recent evidence has shown that the use of LABA/LAMA has cardiovascular benefits in hyperinflated patients with COPD, according to Dr. Hanania, director of the Airways Clinical Research Center at Baylor College of Medicine, Houston.

Meanwhile, emerging data in patients with advanced COPD have demonstrated the benefits of single-inhaler triple therapy with inhaled corticosteroid (ICS)/LABA/LAMA versus LABA/LAMA or ICS/LABA combinations, Dr. Hanania said in an interview.

The past year also has brought news that ICS de-escalation is possible in patients with moderate COPD with no exacerbation risk, though it may not be possible in patients with high baseline blood eosinophils, he added.

Recent developments have not all been about drug therapy. The Zephyr endobronchial valve improved outcomes in patients with little to no collateral ventilation in target lobes, Dr. Hanania said. However, the therapy comes with a potential risk of pneumothorax, so patients need to be monitored in the hospital.

Dr. Hanania provided disclosures related to Roche (Genentech), AstraZeneca, Boehringer Ingelheim, Novartis, GlaxoSmithKline, and Sanofi/Regeneron, as well as institutional research grant support from the National Heart, Lung, and Blood Institute and the American Lung Association.

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