From the Guidelines
Ohtuvayre is indicated for the maintenance treatment of chronic obstructive pulmonary disease (COPD) as a long-acting inhaled bronchodilator maintenance therapy, particularly in symptomatic individuals with moderate and severe disease who are at low risk of future acute exacerbations of COPD (AECOPD). According to the 2023 Canadian Thoracic Society guideline on pharmacotherapy in patients with stable COPD 1, single inhaled LAMA/LABA dual therapy, such as Ohtuvayre, is now indicated for individuals with moderate and severe disease with a low risk of future AECOPD, given its proven superiority over inhaled LAMA or LABA monotherapy in this setting.
Key Points
- Ohtuvayre contains tiotropium, a long-acting muscarinic antagonist (LAMA), and olodaterol, a long-acting beta-2 agonist (LABA), which work together to improve breathing in COPD patients.
- The standard dosage is two inhalations once daily (5 mcg olodaterol/5 mcg tiotropium per inhalation), administered at the same time each day using the Respimat inhaler device.
- Ohtuvayre helps relieve symptoms by relaxing airway muscles through two different mechanisms: tiotropium blocks acetylcholine receptors to prevent bronchoconstriction, while olodaterol stimulates beta-2 receptors to promote bronchodilation.
Considerations
- Ohtuvayre is not intended for acute bronchospasm or as a rescue medication.
- Common side effects include dry mouth, nasopharyngitis, and bronchitis.
- It should be used with caution in patients with narrow-angle glaucoma, urinary retention, or severe cardiovascular disorders, as stated in the example answer, but the 2023 guideline 1 emphasizes the importance of evidence-informed approach that aligns proven effective treatment with symptom burden, risk of future exacerbations, and mortality risk.
From the Research
Indication of Ohtuvayre (Fluticasone Furoate/Vilanterol) for COPD
- Ohtuvayre, a combination of fluticasone furoate and vilanterol, is indicated for the treatment of chronic obstructive pulmonary disease (COPD) 2, 3, 4.
- The effectiveness of fluticasone furoate-vilanterol in COPD management has been demonstrated in clinical trials, showing a significant reduction in the rate of moderate or severe exacerbations compared to usual care 2.
- Studies have also compared the efficacy and safety of fluticasone furoate-vilanterol with other treatments, such as tiotropium, and found similar improvements in lung function and quality of life 3, 4.
Efficacy and Safety of Fluticasone Furoate/Vilanterol in COPD
- Fluticasone furoate-vilanterol has been shown to improve lung function, as measured by forced expiratory volume in 1 second (FEV1), and reduce symptoms and exacerbations in patients with COPD 2, 3, 4.
- The safety profile of fluticasone furoate-vilanterol has been evaluated in clinical trials, with no significant increase in serious adverse events, including pneumonia, compared to other treatments 2, 3.
- However, the use of inhaled corticosteroids, such as fluticasone furoate, has been associated with an increased risk of pneumonia in some studies 3, 5.
Clinical Guidelines and Recommendations for COPD Management
- Clinical guidelines recommend a multidisciplinary approach to managing severe COPD, including the use of long-acting beta-agonists and long-acting muscarinic antagonists, as well as pulmonary rehabilitation 5.
- The use of inhaled corticosteroids, such as fluticasone furoate, is recommended for patients with a history of exacerbations, but the evidence for their effectiveness is not always consistent 5.
- Further research is needed to evaluate the efficacy and safety of different treatments for COPD, including the use of triple therapy (dual long-acting bronchodilators plus an inhaled corticosteroid) as first-line maintenance treatment 6.