From the Guidelines
COPD management should prioritize LABD maintenance therapy in all symptomatic patients with COPD confirmed by spirometry, with a focus on single inhaler dual therapy LABD in those with moderate to severe dyspnea and/or poor health status. This approach is based on the most recent and highest quality study, the 2023 Canadian Thoracic Society guideline on pharmacotherapy in patients with stable COPD 1. The guideline recommends a step-up to single-inhaler triple therapy in those with persistent moderate to severe dyspnea and/or poor health status despite treatment with single inhaler dual therapy with LAMA/LABA or ICS/LABA.
Key components of COPD management include:
- Smoking cessation
- Bronchodilators, such as long-acting beta-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs)
- Pulmonary rehabilitation, which has been shown to reduce dyspnea, increase exercise capacity, and improve quality of life in individuals with COPD 1
- Vaccinations against influenza and pneumococcal disease, which are essential preventive measures 1
- Oxygen therapy for patients with severe hypoxemia
- Exacerbation treatment with increased bronchodilator therapy, systemic corticosteroids, and antibiotics when bacterial infection is suspected
The goal of COPD management is to alleviate symptoms, prevent exacerbations, and reduce mortality, ultimately improving quality of life. By prioritizing LABD maintenance therapy and incorporating non-pharmacological interventions, such as pulmonary rehabilitation and vaccinations, clinicians can provide comprehensive care for patients with COPD.
From the FDA Drug Label
- 2 Maintenance Treatment of Chronic Obstructive Pulmonary Disease Wixela Inhub® 250/50 is indicated for the twice-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema. Wixela Inhub® 250/50 is also indicated to reduce exacerbations of COPD in patients with a history of exacerbations Wixela Inhub® 250/50 twice daily is the only approved dosage for the treatment of COPD because an efficacy advantage of the higher strength Wixela Inhub® 500/50 over Wixela Inhub® 250/50 has not been demonstrated.
The management of COPD with Wixela Inhub involves the twice-daily administration of 250/50 dosage to maintain airflow obstruction and reduce exacerbations in patients with a history of exacerbations 2.
- The recommended dosage is 1 inhalation twice daily, approximately 12 hours apart.
- If shortness of breath occurs between doses, an inhaled short-acting beta2-agonist should be taken for immediate relief.
- Wixela Inhub 250/50 is the only approved dosage for COPD treatment, as no efficacy advantage has been demonstrated for higher strengths 2.
From the Research
COPD Management Overview
- COPD management involves the use of bronchodilators to control symptoms and improve lung function 3, 4, 5.
- Tiotropium bromide is a long-acting anticholinergic bronchodilator that has been shown to be effective in improving lung function and reducing symptoms in patients with COPD 3, 5.
Combination Therapy
- Combination therapy with salmeterol and tiotropium has been shown to be more effective than either medication alone in improving lung function and reducing symptoms in patients with COPD 4, 6.
- The addition of fluticasone propionate/salmeterol to tiotropium has also been shown to improve lung function and reduce rescue medication use in patients with moderate to severe COPD 7.
Tiotropium Bromide Efficacy
- Tiotropium bromide has been shown to be superior to ipratropium bromide in improving lung function and reducing symptoms in patients with COPD 3, 5.
- Tiotropium bromide has also been shown to be at least as effective as salmeterol in improving lung function and reducing symptoms in patients with COPD 3, 5.