![]() Qvar MDI, Qvar Autohaler, Clenil Modulite, Easyhaler beclometasone, Soprobec and Asmabec are 2nd line / non-preferred options.Easyhaler 100 microgrm, Pulmicort ® Turbohaler, and Budelin ® Novolizer - 2nd line option for existing patients, or if patient cannot use or declines preferred inhaler in the Leeds Asthma Algorithmīudesonide nebules for treatment of COPD and asthma - only for those patients who absolutely cannot use any other inhaler device.West Yorkshire Adult Asthma Management and Prescribing Guideline LHP: Allergic rhinitis and non-allergic rhinitis in adults and children over 12 Unless explicitly stated, any brand names included in brackets next to a drug's generic name are there solely to aid searching and identification, and should not be considered to limit use to that specific brand. Leeds and York Partnership NHS Foundation Trustįormulary Chapter 3: Respiratory system - Full Chapter ![]() Single inhaler triple therapy versus inhaled corticosteroid plus long-acting β2-agonist therapy for chronic obstructive pulmonary disease (TRILOGY): a double-blind, parallel group, randomised controlled trial. Efficacy and tolerability of budesonide/formoterol added to tiotropium compared with tiotropium alone in patients with severe or very severe COPD: a randomized, multicentre study in East Asia. Efficacy and safety of umeclidinium added to fluticasone furoate/vilanterol in chronic obstructive pulmonary disease: results of two randomized studies. Siler TM, Kerwin E, Sousa AR, Donald A, Ali R, Church A. Comparison of tiotropium plus fluticasone propionate/salmeterol with tiotropium in COPD: a randomized controlled study. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Global Initiative for Chronic Obstructive Lung Disease. The safety and tolerability profile of BUD/GLY/FOR was also found to be comparable to other triple combination therapies.Ĭhronic obstructive pulmonary disease Exacerbations Inhaled corticosteroid Long-acting muscarinic antagonist Long-acting β2-agonist Lung function Network meta-analysis Patient-reported outcomes Safety Triple therapy. In this NMA, BUD/GLY/FOR 320/18/9.6 μg showed comparable efficacy versus other ICS/LAMA/LABA fixed-dose or open combination therapies in terms of reducing exacerbation rates and improving lung function, symptoms and health-related quality of life in patients with moderate-to-very-severe COPD, in line with previously published meta-analysis results of triple combinations in COPD. Sensitivity analyses and meta-regression results for exacerbation outcomes were broadly in line with the base case NMA. Across all outcomes for exacerbations, lung function, symptoms, health-related quality of life, safety, and tolerability, the efficacy and safety of BUD/GLY/FOR were comparable to those of other triple ICS/LAMA/LABA fixed-dose (fluticasone furoate/umeclidinium/vilanterol and beclomethasone dipropionate/glycopyrronium bromide/formoterol fumarate) and open combinations at or over 24 and 52 weeks. LAMA/LABA dual combinations were combined as a single treatment group to create a connected network. Nineteen studies (n = 37,741 patients) met the inclusion criteria of the review 15 contributed to the base case network. Meta-regression and sensitivity analyses were used to assess heterogeneity across studies. Study results were combined using a three-level hierarchical Bayesian NMA model to assess efficacy and safety outcomes at or over 24 and 52 weeks. The methodologic quality and risk of bias of included studies were assessed. A systematic literature review was conducted to identify ≥ 10-week randomized controlled trials, including ≥ 1 fixed-dose or open combination triple-therapy arm, in patients with moderate-to-very severe COPD. This network meta-analysis (NMA) was conducted to compare the relative efficacy, safety, and tolerability of BUD/GLY/FOR 320/18/9.6 µg with other fixed-dose and open combination triple therapies in COPD over 52 weeks, including data from ETHOS. Subsequently, the ETHOS study was published, including data for 8509 patients, assessing the efficacy and safety of BUD/GLY/FOR over 52 weeks. ![]() A previous network meta-analysis showed comparable efficacy of the ICS/LAMA/LABA, budesonide/glycopyrronium bromide/formoterol fumarate (BUD/GLY/FOR) 320/18/9.6 µg, to other fixed-dose and open combination triple therapies at 24 weeks in COPD. In patients with chronic obstructive pulmonary disease (COPD) who experience further exacerbations or symptoms, despite being prescribed dual long-acting muscarinic antagonist (LAMA)/long-acting β 2-agonist (LABA) or inhaled corticosteroid (ICS)/LABA therapies, triple ICS/LAMA/LABA therapy is recommended.
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