Respiratory Medicine Unit, University "Magna Græcia" of Catanzaro, Catanzaro, Italy,
Respiratory Medicine Unit, University "Magna Græcia" of Catanzaro, Catanzaro, Italy.
Respiration. 2021;100(2):127-134. doi: 10.1159/000512064. Epub 2020 Dec 10.
Triple therapy consisting of a drug association including an inhaled corticosteroid, a long-acting muscarinic receptor antagonist and a long-acting β2-adrenergic agonist, delivered via a single device, can be a valuable treatment for chronic obstructive pulmonary disease (COPD) patients experiencing frequent disease exacerbations.
The aim of this real-life, single-center, observational study was to evaluate, in 44 COPD patients with recurrent exacerbations, the effects of the triple inhaled therapy combining fluticasone furoate, umeclidinium, and vilanterol (FF/UMEC/VI).
Within such a therapeutic context, several clinical and lung functional parameters were considered at baseline and after 24 weeks of treatment with combined inhaled triple therapy.
With respect to baseline, after 24 weeks of treatment with FF/UMEC/VI, significant changes were recorded with regard to Modified British Medical Research Council (p < 0.0001) and COPD Assessment Test (p < 0.0001) scores, COPD exacerbations (p < 0.001), forced expiratory volume in the first second (p < 0.001), residual volume (p < 0.01), forced mid-expiratory flow between 25 and 75% of FVC (p < 0.0001), inspiratory capacity (p < 0.01), forced vital capacity (p < 0.05), and peak expiratory flow (p < 0.0001). Moreover, in a subgroup of 28 patients, a significant increase of diffusion lung capacity (p < 0.01) was also detected.
In conclusion, our real-life results suggest that triple inhaled therapy with FF/UMEC/VI, when given to COPD patients with frequent exacerbations, is able to positively impact on dyspnea and global health status as well as to significantly decrease COPD exacerbations and improve airflow limitation and lung hyperinflation.
由一种吸入性皮质类固醇、一种长效毒蕈碱受体拮抗剂和一种长效β2-肾上腺素能激动剂组成的三联疗法，通过单一装置给药，可为频繁发生疾病加重的慢性阻塞性肺疾病（COPD）患者提供有价值的治疗。
本真实世界、单中心、观察性研究的目的是在 44 例频繁发生疾病加重的 COPD 患者中评估三联吸入疗法（氟替卡松糠酸酯、乌美溴铵和维兰特罗）联合治疗的效果。
在这种治疗背景下，在开始三联吸入治疗后 24 周时，我们考虑了几个临床和肺功能参数。
与基线相比，在开始三联吸入治疗后 24 周时，我们记录到改良英国医学研究理事会（p<0.0001）和 COPD 评估测试（p<0.0001）评分、COPD 加重（p<0.001）、第一秒用力呼气量（p<0.001）、残气量（p<0.01）、用力呼气流量在 25%至 75%肺活量之间（p<0.0001）、吸气量（p<0.01）、用力肺活量（p<0.05）和呼气峰值流量（p<0.0001）均有显著变化。此外，在 28 例患者的亚组中，还检测到弥散肺容量的显著增加（p<0.01）。
总之，我们的真实世界研究结果表明，在频繁发生疾病加重的 COPD 患者中，使用 FF/UMEC/VI 三联吸入疗法治疗，能够对呼吸困难和整体健康状况产生积极影响，显著降低 COPD 加重的发生率，改善气流受限和肺过度充气。
