Triple inhaled therapy for chronic obstructive pulmonary disease

Paolo Montuschi; Mario Malerba; Giuseppe Macis; Nadia Mores; Giuseppe Santini

doi:10.1016/j.drudis.2016.07.009

Triple inhaled therapy for chronic obstructive pulmonary disease

Drug Discov Today. 2016 Nov;21(11):1820-1827. doi: 10.1016/j.drudis.2016.07.009. Epub 2016 Jul 21.

Authors

Paolo Montuschi¹, Mario Malerba², Giuseppe Macis³, Nadia Mores⁴, Giuseppe Santini⁴

Affiliations

¹ Department of Pharmacology, Faculty of Medicine, University Hospital Agostino Gemelli, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: [email protected].
² Department of Internal Medicine, University of Brescia, Brescia, Italy.
³ Department of Radiological Sciences, Faculty of Medicine, University Hospital Agostino Gemelli, Catholic University of the Sacred Heart, Rome, Italy.
⁴ Department of Pharmacology, Faculty of Medicine, University Hospital Agostino Gemelli, Catholic University of the Sacred Heart, Rome, Italy.

PMID: 27452453
DOI: 10.1016/j.drudis.2016.07.009

Abstract

Combining individual drugs in a single inhaler is the most convenient way to deliver triple therapy. A long-acting muscarinic receptor antagonist (LAMA) added to an inhaled corticosteroid (ICS)/long-acting β₂-adrenoceptor agonist (LABA) fixed-dose combination (FDC) can improve efficacy of pharmacological treatment of patients with chronic obstructive pulmonary disease (COPD). New inhaled ICS/LABA/LAMA FDCs, including fluticasone furoate/vilanterol/umeclidinium, budesonide/formoterol/glycopyrronium and beclometasone/formoterol/glycopyrronium, are in Phase III of clinical development for COPD. Triple inhaled therapy might be particularly useful in patients with severe to very severe COPD, above all in those with peripheral blood or sputum eosinophilia, asthma-COPD overlap syndrome (ACOS) or frequent exacerbators. Future prospective studies should assess efficacy and safety of triple ICS/LABA/LAMA therapy in selected COPD phenotypes.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Administration, Inhalation
Adrenal Cortex Hormones / adverse effects
Adrenal Cortex Hormones / therapeutic use*
Adrenergic beta-2 Receptor Agonists / adverse effects
Adrenergic beta-2 Receptor Agonists / therapeutic use*
Drug Therapy, Combination
Humans
Muscarinic Antagonists / adverse effects
Muscarinic Antagonists / therapeutic use*
Pulmonary Disease, Chronic Obstructive / drug therapy*

Substances

Adrenal Cortex Hormones
Adrenergic beta-2 Receptor Agonists
Muscarinic Antagonists