New triple combination of beclomethasone dipropionate, glycopyrronium bromide and formoterol fumarate in the treatment of chronic obstructive pulmonary disease
https://doi.org/10.18093/0869-0189-2021-31-3-365-373
Abstract
Therapeutical options for the treatment of chronic obstructive pulmonary disease (COPD) have significantly expanded in recent years, primarily due to market entry of new combination drugs. One of the commonly used therapeutic options for patients with frequent exacerbations of COPD is a triple combination, including LABA, LAMA and ICS, however, prescribing such therapy, doctors often face a decrease in treatment adherence, which ultimately leads to lack of effectiveness, as well as with an increased risk of adverse events. This article presents the current information on the clinical efficacy and safety profile of a fixed triple combination of beclomethasone dipropionate, glycopyrronium bromide and formoterol fumarate, available as extrafine aerosol inhaler, allows to optimize inhalation treatment for patients with frequent exacerbations of COPD.
Keywords
About the Authors
S. N. AvdeevRussian Federation
Sergey N. Avdeev, Doctor of Medicine, Professor, Corresponding Member of Russian Academy of Sciences, Head of Department of Pulmonology, I.M.Sechenov First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University); Leading Researcher, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
ul. Trubetskaya 8, build. 2, Moscow, 119991
Orekhovyy bul’var 28, Moscow, 115682
tel.: (495) 708-35-76
N. V. Trushenko
Russian Federation
Natalia V. Trushenko, Candidate of Medicine; Assistant Lecturer, Department of Pulmonology, I.M.Sechenov First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University); Researcher, Scientific and Methodological Center for Monitoring and Control of Respiratory Diseases, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
ul. Trubetskaya 8, build. 2, Moscow, 119991
Orekhovyy bul’var 28, Moscow, 115682
tel.: (495) 708-35-76
References
1. Aisanov Z., Avdeev S., Arkhipov V. et al. Russian guidelines for the management of COPD: algorithm of pharmacologic treatment. Int. J. COPD. 2018; 13: 183–187. DOI: 10.2147/COPD.S153770.
2. Hogg J.C., Chu F., Utokaparch S. et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease. N. Engl. J. Med. 2004; 350 (26): 2645–2653. DOI: 10.1056/NEJMoa032158.
3. Higham A., Quinn A.M., Cançado J.E.D., Singh D. The pathology of small airways disease in COPD: historical aspects and future directions. Respir. Res. 2019; 20 (1): 49. DOI: 10.1186/s12931-0191017-y.
4. Avdeev S.N., Trushenko N.V. [Triple therapy in chronic obstructive pulmonary disease]. Pul’monologiya. 2019; 29 (2): 199–206. DOI: 10.18093/0869-0189-2019-29-2-199-206 (in Russian).
5. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Revised 2021. Available at: https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf
6. Hersh C.P., Washko G.R., Estépar R.S.J. et al. Paired inspiratory-expiratory chest CT scans to assess for small airways disease in COPD. Respir. Res. 2013; 14 (1): 42. DOI: 10.1186/1465-9921-14-42.
7. Crisafulli E., Pisi R., Aiello M. et al. Prevalence of small-airway dysfunction among COPD patients with different GOLD stages and its role in the impact of disease. Respiration. 2017; 93 (1): 32–41. DOI: 10.1159/000452479.
8. Suissa S., Dell’Aniello S., Ernst P. Comparative effectiveness of LABA-ICS versus LAMA as initial treatment in COPD targeted by blood eosinophils: a population-based cohort study. Lancet Respir. Med. 2018; 6 (11): 855–862. DOI: 10.1016/S2213-2600(18)30368-0.
9. Lipson D.A., Barnhart F., Brealey N. et al. Once-daily single-inhaler triple versus dual therapy in patients with COPD. N. Engl. J. Med. 2018; 378 (18): 1671–1680. DOI: 10.1056/NEJMoa1713901.
10. Avdeev S.N., Nevzorova V.A., Kudelya L.M. et al. [Issues of triple therapy of chronic obstructive pulmonary disease. Comments to the algorithm. A resolution of expert panel, June 13, 2018, Vladivostok]. Pul’monologiya. 2019; 29 (3): 365–374. DOI: 10.18093/0869-0189-2019-29-3-365-374.
11. Singh D., Corradi M., Spinola M. et al. Triple therapy in COPD: new evidence with the extrafine fixed combination of beclomethasone dipropionate, formoterol fumarate, and glycopyrronium bromide. Int. J. COPD. 2017; 12: 2917–2928. DOI: 10.2147/COPD.S146822.
12. Vestbo J., Papi A., Corradi M. et al. Single inhaler extrafine triple therapy versus long-acting muscarinic antagonist therapy for chronic obstructive pulmonary disease (TRINITY): a double-blind, parallel group, randomised controlled trial. Lancet. 2017; 389 (10082): 1919–1929. DOI: 10.1016/S0140-6736(17)30188-5.
13. Papi A., Vestbo J., Fabbri L. et al. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial. Lancet. 2018; 391 (10125): 1076–1084. DOI: 10.1016/S0140-6736(18)30206-X.
14. Georges G., Zheng J.P., Li Z. et al. Effect of extra-fine triple therapy with beclomethasone dipropionate/formoterol fumarate/glycopyrronium bromide (BDP/FF/GB) pressurized metered dose inhaler (PMDI) on exacerbatioms in East Asian patients with COPD: the TRIVERSYTI study. Chest. 2020; 158 (4, Suppl.): A1785–1786. DOI: 10.1016/j.chest.2020.08.1557.
15. Koo H.K., Vasilescu D.M., Booth S. et al. Small airways disease in mild and moderate chronic obstructive pulmonary disease: a cross-sectional study. Lancet Respir. Med. 2018; 6 (8): 591–602. DOI: 10.1016/S2213-2600(18)30196-6.
16. Usmani O.S. Treating the small airways. Respiration. 2012; 84 (6): 441–453. DOI: 10.1159/000343629.
17. De Backer W., Devolder A., Poli G. et al. Lung deposition of BDP/ formoterol HFA pMDI in healthy volunteers, asthmatic, and COPD patients. J. Aerosol. Med. Pulm. Drug Deliv. 2010; 23 (3): 137–148. DOI: 10.1089/jamp.2009.0772.
18. Singh D., Fabbri L.M., Corradi M. et al. Extrafine triple therapy in patients with symptomatic COPD and history of one moderate exacerbation. Eur. Respir. J. 2019; 53 (5): 1900235. DOI: 10.1183/13993003.00235-2019.
19. De Backer J.W., Vos W.G., Vinchurkar S.C. et al. Validation of computational fluid dynamics in CT-based airway models with SPECT/CT. Radiology. 2010; 257 (3): 854–862. DOI: 10.1148/radiol.10100322.
20. Kappeler D., Sommerer K., Kietzig C. et al. Lung deposition of fluticasone propionate/formoterol administered via a breath-triggered inhaler. Eur. Respir J. 2017; 50 (Suppl. 61): PA522. DOI:10.1183/1393003.congress-2017.PA522.
21. Müllinger B., Brand P., Fischer A. et al. Intra-pulmonal deposition of two different tobramycin formulations. J. Cyst. Fibros. 2005; 4 (Suppl. 1): S53 (Abs. 198). Available at: https://core.ac.uk/download/pdf/82229439.pdf
22. De Backer W., Devolder A., Poli G. et al. Lung deposition of BDP/ formoterol HFA pMDI in healthy volunteers, asthmatic, and COPD patients. J. Aerosol. Med. Pulm. Drug Deliv. 2010; 23 (3): 137–148. DOI: 10.1089/jamp.2009.0772.
23. Usmani O.S., Scichilone N., Mignot B. et al. Airway deposition of extrafine inhaled triple therapy in patients with COPD: A model approach based on functional respiratory imaging computer simulations. Int. J. Chron. Obstruct. Pulmon. Dis. 2020; 15: 2433–2440. DOI: 10.2147/COPD.S269001.
24. Sonnappa S., Martin R., Israel E. et al. Risk of pneumonia in obstructive lung disease: A real-life study comparing extra-fine and fine-particle inhaled corticosteroids. PLoS One. 2017; 12 (6): e0178112. DOI: 10.1371/journal.pone.0178112.
25. Hovelmann R., Georges G., Bahari Javan S. et al. TriOptimize VI: The use of extrafine single inhaler triple therapy improves adherence to treatment in patients with COPD – Real-world evidence. Am. J. Respir. Crit. Care Med. 2020; 201: A4303. DOI: 10.1164/ajrccm-conference.2020.201.1_MeetingAbstracts.A4303.
26. Vestbo J., Fabbri L., Papi A. et al. Inhaled corticosteroid containing combinations and mortality in COPD. Eur. Respir. J. 2018; 52 (6): 1801230. DOI: 10.1183/13993003.01230-2018.
Review
For citations:
Avdeev S.N., Trushenko N.V. New triple combination of beclomethasone dipropionate, glycopyrronium bromide and formoterol fumarate in the treatment of chronic obstructive pulmonary disease. PULMONOLOGIYA. 2021;31(3):365-373. (In Russ.) https://doi.org/10.18093/0869-0189-2021-31-3-365-373