Chronic obstructive pulmonary disease: mono-, double-, triple therapy…
https://doi.org/10.18093/0869-0189-2018-28-2-234-242
Abstract
General criteria for choosing basic pharmacotherapy (inhaled β-agonists, M-cholinolytics, inhaled steroids (ICS), and theophylline) for long-term treatment of patients with chronic obstructive pulmonary diseases (COPD) are given in the article. The authors described a role of ICS in the current management of COPD patients. Possibility of ICS withdrawal in COPD patients without increase in the risk of exacerbations and a clinical approach to revision of the therapy were discussed. The authors analyzed currently available evidence of efficacy of dual bronchodilation as the key point of modern therapeutic strategy for COPD. A choice of single or dual bronchodilation should be guided by certain criteria. Russian and international clinical algorithms of pharmacotherapy for COPD were also reviewed.
About the Authors
K. A. Zykov
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia;
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia, Moscow
Russian Federation
Doctor of Medicine, Professor, Deputy Director for Academic Affairs and Innovation, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Head of Laboratory of Pulmonology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia
Russian Federation
Doctor of Medicine, Professor, Deputy Director for Academic Affairs and Innovation, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Head of Laboratory of Pulmonology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia
A. V. Rvacheva
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia, Moscow
Russian Federation
Candidate of Medicine, Leading Researcher, Laboratory of Pulmonology
Russian Federation
Candidate of Medicine, Leading Researcher, Laboratory of Pulmonology
V. I. Kobylyanskiy
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
Russian Federation
Doctor of Medicine, Professor, Educational Center, Federal Pulmonology Research Institute
Russian Federation
Doctor of Medicine, Professor, Educational Center, Federal Pulmonology Research Institute
G. L. Osipova
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
Russian Federation
Doctor of Medicine, Professor, Head of Division of Clinical Trials
Russian Federation
Doctor of Medicine, Professor, Head of Division of Clinical Trials
A. R. Tatarskiy
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
Russian Federation
Doctor of Medicine, Professor, Head of Educational Center
Russian Federation
Doctor of Medicine, Professor, Head of Educational Center
E. I. Sokolov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia, Moscow
Russian Federation
Doctor of Medicine, Professor, Academician of Russian Academy of Science, Head of Department of General Internal Medicine and Occupational Diseases
Russian Federation
Doctor of Medicine, Professor, Academician of Russian Academy of Science, Head of Department of General Internal Medicine and Occupational Diseases
References
1. Landis S.H., Muellerova H., Mannino D.M. et al. Continuing to confront COPD International patient survey: methods, COPD prevalence, and disease burden in 2012 – 2013. Int. J. Chron. Obstruct. Pulmon. Dis. 2014; 9 (1): 597–611. DOI: 10.2147/COPD.S61854.
2. Chuchalin A.G., Khaltaev N, Antonov N.S. et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int. J. Chron. Obstruct. Pulmon. Dis. 2014; 9 (1): 963–974. DOI: 10.2147/COPD.S67283.
3. Miravitlles M., Vogelmeier C., Roche N. et.al. A review of national guidelines for management of COPD in Europe. Eur. Respir. J. 2016; 47 (2): 625–637. DOI: 10.1183/13993003.01170-2015.
4. Vogelmeier C.F., Criner G.J., Martinez F.J. et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung isease 2017 report: GOLD executive summary. Eur. Respir. J. 2017; 49 (3): 1700214. DOI: 10.1183/13993003.00214-2017.
5. Ito K., Lim S., Caramori G. et al. A molecular mechanism of action of theophylline: induction of histone deacetylase activity to decrease inflammatory gene expression. Proc. Natl. Acad. Sci. USA. 2002; 99 (13): 8921–8926. DOI: 10.1073/pnas.132556899.
6. Cosío B.G., Shafiek H., Iglesias A. et al. Oral low-dose theophylline on top of Inhaled fluticasone-salmeterol does not reduce txacerbations in patients with severe COPD: a pilot clinical trial. Chest. 2016; 150 (1): 123–130. DOI: 10.1016/j.chest.2016.04.011.
7. Zhu B., Haghi M., Goud M. et al. The formulation of a pressurized metered dose inhaler containing theophylline for inhalation. Eur. J. Pharm. Sci. 2015; 76: 68–72. DOI: 10.1016/j.ejps.2015.04.016.
8. Malamatari M., Somavarapu S., Kachrimanis K. et al. Preparation of theophylline inhalable microcomposite particles by wet milling and spray drying: the influence of mannitol as a co-milling agent. Int. J. Pharm. 2016; 514 (1): 200–211. DOI: 1016/j.ijpharm.2016.06.032.
9. Toledo-Pons N., Cosío B. Is there room for theophylline in COPD? Arch. Bronconeumol. 2017; 53 (10): 539–540. DOI: 10.1016/j.arbres.2017.05.022.
10. Magnussen H., Disse B., Rodriguez-Roisin R. et al. Withdrawal of inhaled glucocorticoids and exacerbations of COPD. N. Engl. J. Med. 2014; 371 (14): 1285–1294. DOI: 10.1056/NEJMoa1407154.
11. Watz H., Tetzlaff K, Wouters E.F. et al. Blood eosinophil count and exacerbations in severe chronic obstructive pulmonary disease after withdrawal of inhaled corticosteroids: a post-hoc analysis of the WISDOM trial. Lancet Respir. Med. 2016; 4 (5): 390–398. DOI: 10.1016/S2213-2600(16)00100-4.
12. Roche N., Chapman K.R., Vogelmeier C.F. et al. Blood eosinophils and response to maintenance chronic obstructive pulmonary disease treatment. Data from the FLAME trial. Am. J. Respir. Crit. Care Med. 2017; 195 (9): 1189–1197. DOI: 10.1164/rccm.201701-0193OC.
13. Wedzicha J.A., Zhong N., Ichinose M. et al. Indacaterol/glycopyrronium versus salmeterol/fluticasone in Asian patients with COPD at a high risk of exacerbations: results from the FLAME study. Int. J. Chron. Obstruct. Pulmon. Dis. 2017; 12: 339–349. DOI: 10.2147/COPD.S125058.
14. Decramer M., Celli B., Kesten S. et al. Effect of tiotropium on outcomes in patients with moderate chronic obstructive pulmonary disease (UPLIFT): a prespecified subgroup analysis of a randomised controlled trial. Lancet. 2009; 374 (9696): 1171–1178. DOI: 10.1016/S0140-6736(09)61298-8.
15. Singh D., Gaga M., Schmidt O. et al. Effects of tiotropium + olodaterol versus tiotropium or placebo by COPD disease severity and previous treatment history in the OTEMTO® studies. Respir. Res. 2016; 17 (1): 73. DOI: 10.1186/s12931-016-0387-7.
16. Zykov K.A., Ovcharenko S.I. Approaches to drug therapy for COPD in Russia: a proposed therapeutic algorithm. Int. J. Chron. Obstruct. Pulmon. Dis. 2017; 12: 1125–1133.DOI: 10.2147/COPD.S125594.
17. Zykov K.A., Ovcharenko S.I. An approach to pharmacological treatment of patients with stable COPD: a suggested therapeutic algorithm. Meditsinsky Sovet. 2015; (17): 24–31 (in Russian).
18. Tudoric N., Koblizek V, Miravitlles M. et al. GOLD 2017 on the way to a phenotypic approach? Analysis from the phenotypes of COPD in Central and Eastern Europe (POPE) cohort. Eur. Respir. J. 2017; 49 (4): pii: 1602518. DOI: 10.1183/13993003.02518-2016.
19. Thomas M., Halpin D., Miravitlles M. When is dual bronchodilation indicated in COPD? Int. J. Chron. Obstruct. Pulmon. Dis. 2017; 12: 2291–2305. DOI: 10.2147/COPD.S138554.
20. Buhl R., Maltais F., Abrahams R. et al. Tiotropium and olodaterol fixed dose combination versus mono-components in COPD (GOLD 2–4). Eur. Respir. J. 2015; 45 (4): 969–979. DOI: 10.1183/09031936.00136014.
21. Beeh K.M., Westerman J., Kirsten A.M. et al. The 24-h lung-function profile of once-daily tiotropium and olodaterol fixed-dose combination in chronic obstructive pulmonary disease. Pulm. Pharmacol. Ther. 2015; (32): 53–59. DOI: 10.1016/j.pupt.2015.04.002.
22. Buhl R., McGarvey L., Korn S. et al. Benefits of tiotropium/olodaterol over tiotropium at delaying clinically significant events in patients with COPD classified as GOLD B. Thorax. 2016; 71 (Suppl. 3): P294. DOI: 10.1136/thoraxjnl-2016-209333.437.
23. Yawn B.P., Thomashow B., Mannino D.M. et al. The 2017 Update to the COPD Foundation COPD Pocket Consultant Guide. Chronic. Obstr. Pulm. Dis. 2017; 4 (3): 177–185. DOI: 10.15326/jcopdf.4.3.2017.0136.
24. Chuchalin A.G., Avdeev S.N., Aisanov Z.R., eds. Clinical Guidelines on COPD. Moscow: Rossiyskoye respiratornoye obshchestvo; 2017. Available at: www.spulmo.ru (in Russian).
Review
For citations:
Zykov K.A., Rvacheva A.V., Kobylyanskiy V.I., Osipova G.L., Tatarskiy A.R., Sokolov E.I. Chronic obstructive pulmonary disease: mono-, double-, triple therapy…. PULMONOLOGIYA. 2018;28(2):234-242. (In Russ.) https://doi.org/10.18093/0869-0189-2018-28-2-234-242
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