#LAMA LABA FOR COPD TRIAL#

Incidence of first moderate or severe exacerbation events was 320.6 per 1,000 person-years for the LAMA-LABA group and 363.6 per 1,000 person-years for the ICS-LABA group. At baseline, 9.6% had a moderate or severe exacerbation in the prior 30 days. Common comorbidities included hypertension in 78%, coronary heart disease in 36%, diabetes in 31%, and gastroesophageal reflux disease and peripheral vascular disease in about 29%, among a host of other conditions. Patients prescribed LAMA-LABAs were more likely to have spirometry measurements at baseline than those prescribed ICS-LABAs (50.2% vs 30.7%) and were more likely to have received an index prescription from a pulmonologist (11.4% vs 4.5%).Īfter propensity-score matching, the 30,216 matched pairs were well-balanced: patients had an average age of 70 years and were evenly split between men and women.

#LAMA LABA FOR COPD TRIAL#

'Our study should not be interpreted as a decisive verdict on the conflicting clinical trial data in FLAME, IMPACT, and ETHOS, but rather as one piece of additional evidence to help shape clinical guidelines.' 'Because physicians frequently prescribe inhalers to patients who would not meet entry criteria for inclusion in COPD trials, the relative effectiveness of LAMA-LABA therapy compared with ICS-LABA therapy may differ in routine clinical practice,' they continued. 'Patients in our study appear to have substantially lower baseline risk than in all three of the other trials,' Feldman and co-authors wrote in their discussion. Results of FLAME, meanwhile, were more in line with the current study, demonstrating a 22% reduction in the rate of first moderate or severe exacerbation with LAMA-LABA therapy. The IMPACT and ETHOS trials, for example, showed lower COPD exacerbation rates with ICS-LABA inhalers, despite more cases of pneumonia. Guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend LAMA-LABA inhalers as combination therapy for COPD, though randomized trials have offered up conflicting evidence, the researchers noted. LAMA-LABA therapy was also associated with a 20% reduction in first pneumonia hospitalization rates (HR 0.80, 95% CI 0.75-0.86), a finding that was consistent across prespecified subgroup and sensitivity analyses, according to their findings in JAMA Internal Medicine.

Lama laba for copd