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Role of dual bronchodilators in COPD: A review of the current evidence for indacaterol/glycopyrronium

机译：双支气管扩张剂在COPD中的作用：对吲哚/甘油糖酮的当前证据进行审查

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摘要

In this review, we summarize the rationale for combining long-acting bronchodilators in the management of chronic obstructive pulmonary disease (COPD), and the evidence for the long-acting bronchodilator combination indacaterol/glycopyrronium (IND/GLY). Clinical practice guidelines generally recommend the use of long-acting bronchodilators in the treatment of patients with all severities of COPD, either as a first-choice or alternative-choice therapy. Combining classes of long-acting bronchodilators can result in superior improvements in lung function and clinical outcomes compared with bronchodilator monotherapy, as observed in studies of free combinations of long-acting beta 2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs). LABA/LAMA fixed-dose combinations (FDCs) can also significantly improve lung function, dyspnea, symptoms and health status and reduce exacerbations and rescue medication use versus an inhaled corticosteroid/LABA, with a comparable safety profile and lower incidence of pneumonia. The LABA/LAMA FDC of IND/GLY is approved for use in the management of COPD. This review summarizes the evidence for IND/GLY, including its pharmacodynamic and pharmacokinetic profile, and published efficacy and safety data from clinical trials in patients with COPD. We also explore the unmet needs in COPD and discuss the potential future of COPD management. (C) 2017 The Authors. Published by Elsevier Ltd.
机译：在本文中，我们总结了在慢性阻塞性肺病（COPD）管理中结合长效支气管扩张剂的理由，以及长效支气管扩张剂组合吲哚替洛克/糖酮（IND / GLY）的证据。临床实践指南普遍建议使用长效支气管扩张剂在治疗患者的所有患者的患者中，作为首选或替代选择疗法。与支气管扩张剂单药治疗相比，长效支气管扩张剂的组合可能导致肺功能和临床结果的卓越改善，如在长效β2-激动剂（Labas）和长效的毒蕈族拮抗剂（Lamas）的自由组合中所观察到的。 Laba / Lama固定剂量组合（FDCs）还可以显着改善肺功能，呼吸困难，症状和健康状况，并减少加剧和救援药物使用与吸入的皮质类固醇/拉巴，具有可比的安全性曲线和肺炎的发病率降低。 Ind / Gly的Laba / Lama FDC被批准用于COPD的管理。本综述总结了IND / GLY的证据，包括其药效学和药代动力学概况，以及来自COPD患者的临床试验的疗效和安全数据。我们还探讨了COPD中的未满足需求，并讨论了COPD管理的潜在未来。 （c）2017作者。 elsevier有限公司出版

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