From the Guidelines
The latest treatment for Chronic Obstructive Pulmonary Disease (COPD) involves LABD maintenance therapy in all symptomatic patients, with single inhaler dual therapy LABD recommended for those with moderate to severe dyspnea and/or poor health status. According to the 2023 Canadian Thoracic Society guideline on pharmacotherapy in patients with stable COPD 1, this approach focuses on three outcome areas: symptoms, exacerbations, and mortality. The guideline recommends a step-up to single-inhaler triple therapy in patients 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:
- LABD maintenance therapy for all symptomatic patients confirmed by spirometry
- Single inhaler dual therapy LABD for those with moderate to severe dyspnea and/or poor health status
- Single-inhaler triple therapy for patients with persistent symptoms despite dual therapy
- SITT (Triple therapy) for patients at high risk of acute exacerbations of COPD (AECOPD)
The goal of these treatments is to alleviate symptoms, prevent exacerbations, and reduce mortality, ultimately improving the quality of life for COPD patients 1. By implementing these evidence-based recommendations, clinicians can provide optimal care for patients with COPD, addressing not only their symptoms but also their overall health status and risk of exacerbations.
From the FDA Drug Label
1.1 Maintenance Treatment of COPD STIOLTO RESPIMAT is a combination of tiotropium bromide and olodaterol indicated for long-term, once-daily maintenance treatment of patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema 1.2 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.
The latest treatments for Chronic Obstructive Pulmonary Disease (COPD) include:
- STIOLTO RESPIMAT: a combination of tiotropium bromide and olodaterol, indicated for long-term, once-daily maintenance treatment of COPD.
- Wixela Inhub: a twice-daily maintenance treatment for airflow obstruction in patients with COPD, including chronic bronchitis and/or emphysema 2, 3, 3.
From the Research
Latest Treatments for COPD
The latest treatments for Chronic Obstructive Pulmonary Disease (COPD) include:
- Inhaled bronchodilator therapy with long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) in combination, which is currently the mainstay of treatment for COPD 4
- The addition of inhaled corticosteroids (ICS) to LABA/LAMA only in patients with a history of frequent/severe exacerbations and high blood eosinophil counts, or in those with concomitant asthma 4
- Tiotropium, a long-acting muscarinic antagonist, which has been shown to be safe and efficacious as a long-term, once-daily treatment for COPD and for reducing COPD exacerbations 5
- Other LAMAs, such as glycopyrronium and umeclidinium, which have been developed in recent years and have shown improvements in lung function, exacerbations, breathlessness, and health status in patients with COPD 6
Combination Therapies
Combination therapies, such as LABA/LAMA, are also being used to treat COPD, with studies showing that they can provide additional benefits over monotherapy 7, 8
- The Global Initiative for Chronic Obstructive Lung Disease 2022 report recommends initial pharmacological treatment with a LAMA or a LABA as monotherapy for most patients, or dual bronchodilator therapy (LABA/LAMA) in patients with more severe symptoms, regardless of exacerbation history 8
- The American Thoracic Society treatment guidelines strongly recommend LABA/LAMA combination therapy over LAMA or LABA monotherapy in patients with COPD and dyspnea or exercise intolerance 8
Patient-Specific Treatments
Patient-specific treatments are also being developed, with studies showing that subphenotyping of patients with COPD (e.g., frequent exacerbations, sputum eosinophilia, mixed asthma/COPD phenotype) can help identify those patients who are most likely to benefit from addition of ICS to bronchodilating treatment 7
- A clinical guide to the use of add-on therapies with LABA/LAMA for different patient phenotypes has been developed, including patients still symptomatic (but not exacerbating) despite LABA/LAMA treatment, patients still exacerbating despite LABA/LAMA treatment who have high blood eosinophil counts, and patients still exacerbating despite LABA/LAMA treatment who do not have high blood eosinophils or concomitant asthma 4