8/2/2023 0 Comments Facts trelegy ics laba lamaFF/UMEC/VI was found to be significantly more effective at increasing trough FEV1 (based on change from baseline) at 12 weeks than all triple comparators, apart from TIO (tiotropium) 18 + SAL/FP (salmeterol/fluticasone propionate), TIO 18 + BDP/FOR (beclomethasone dipropionate/formoterol), and UMEC+FF/VI. Various comparator therapies taken into account were Umeclidinium+Fluticasone furoate/Vilanterol (UMEC+FF/VI), Tiotropium+Salmetrol/Fluticasone propionate (TIO+SAL/FP), Tiotropium+Budesonide/Formoterol (TIO+BUD/FOR), Budesonide/Glycopyrronium/Formoterol (BUD/GLY/FOR), etc. After screening, 15 studies were identified as reporting FEV 1 data at 12 weeks and 5 studies at 24 weeks. Also, both fixed and random effects were used in this network meta analysis. As an assessment parameter, mean difference in change from baseline at weeks 12 and 24 in trough forced expiratory volume in 1 s (FEV 1) was determined. In this, a systematic literature review was performed on randomized control trials in adults aged 40 years or older with COPD. The study included single-inhaler as well as multiple inhalers. GSK, at the Americal Thoracic Society (ATS) conference, 2022, presented a comparative efficacy study of Fluticasone/Umeclidinium/Vilanterol (FF/UMEC/VI) versus other triple therapies for the treatment of COPD based on the literature review and network meta analysis. Often, separate inhalers are also used to administer the medication in combination, such as Spiriva Handihaler (Tiotropium, from Boehringer Ingelheim) may be used along with Advair Diskus (salmetrol/fluticasone from GlaxoSmithKline). There are several brands available for triple therapy with different molecule combinations, some of which are- Breztri Aerosphere (glycopyrronium/ formoterol/ budesonide from Astrazeneca), Trimbow (glycopyrronium/ formoterol/beclometasone from Chiesi Farmaceutici) and Trelegy Ellipta (umeclidinium/vilanterol/fluticasone from GlaxoSmithKline). The combination therapy may also be considered as a first-line of treatment for severe cases of COPD. As per Global Initiative for Chronic Obstructive Lung Disease (GOLD), patients with recurrent exacerbations are recommended triple therapy instead of mono or dual therapy. Triple therapy helps in improving lung function while providing remission in symptoms and exacerbation prevention. These therapies may be administered in combination like dual therapy (LAMA/LABA or LABA/ICS) and triple therapy (LAMA/LABA/ICS). Under medications category, pharmacological therapies are included such as Muscarinic antagonists (Short-acting and Long-acting Muscarinic antagonists), Beta-2 adrenergic agonists (Short-acting and Long-acting beta agonists), Corticosteroids, and Phosphodiesterase-4 inhibitors administered by Oral or Inhalation route. Additionally, surgery might involve bullectomy, lung volume reduction and lung transplant but are considered as less preferred alternatives. Therapy comprises of pulmonary rehabilitation program which is an approach employed to teach the patient how to manage COPD symptoms to improve the quality of life. Supportive care involves oxygen therapy while self-care aids in improving health through physical exercise and smoking cessation. Primarily, COPD care options are- Supportive care, Self-care, Therapy, Surgery, and Medication. Its high mortality rate makes it imperative to have safer and efficacious treatment options available, which could ratchet down the disease-associated death rate. COPD is associated with other concomitant chronic diseases, which increase its morbidity and mortality. These include genetic abnormalities, accelerated aging, and abnormal lung development. Besides exposure, intrinsic factors predispose individuals to develop COPD. The primary factor for COPD is tobacco smoking, but other environmental exposures such as biomass fuel exposure and air pollution may also contribute to the development of the disease. Chronic Obstructive Pulmonary Disease (COPD) is a condition which is characterized by airflow limitation, causing either airflow obstruction or a combination of diseases.
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