Indacaterol/glycopyrronium reduces the risk of clinically important deterioration after direct switch from baseline therapies in patients with moderate COPD: a post hoc analysis of the CRYSTAL study.
Int J Chron Obstruct Pulmon Dis
; 13: 1229-1237, 2018.
Article
em En
| MEDLINE
| ID: mdl-29713156
ABSTRACT
PURPOSE:
COPD is a progressive disease characterized by exacerbations and a decline in health status and lung function. Clinically important deterioration (CID) is a composite endpoint used to evaluate treatment efficacy. This analysis evaluated the impact of a direct switch to once-daily indacaterol/glycopyrronium 110/50 µg (IND/GLY) from previous monotherapy with a long-acting ß2-agonist (LABA) or long-acting muscarinic antagonist (LAMA) or with an LABA and an inhaled corticosteroid (LABA + ICS) on reducing CID.METHODS:
CRYSTAL was a 12-week, prospective, multicenter, randomized, open-label study conducted in clinical practice settings. Three definitions of CID (D1-D3) were used, including 1) ≥100 mL decrease in trough forced expiratory volume in 1 second (FEV1), 2) ≥1 point decrease in transition dyspnea index (TDI) and/or ≥0.4 points increase in clinical COPD questionnaire score (CCQ), or 3) an acute moderate/severe exacerbation (AECOPD). In D1 and D2, either TDI or CCQ was evaluated along with FEV1 and AECOPD, whereas in D3, all 4 parameters were included. ClinicalTrials.gov number NCT01985334.RESULTS:
Of the 2,159 patients analyzed, 1,622 switched to IND/GLY and 537 continued their baseline treatments. The percentage of patients with a CID was significantly lower after a direct switch to IND/GLY versus LABA or LAMA using all 3 CID definitions (D1 odds ratio [OR] 0.41 [95% CI 0.30-0.55]; D2 OR 0.41 [95% CI 0.31-0.55]; D3 OR 0.39 [95% CI 0.29-0.52]). Compared with LABA + ICS, IND/GLY also reduced the risk of CID (D1 OR 0.76 [95% CI 0.56-1.02]; D2 OR 0.75 [95% CI 0.56-1.00]; D3 OR 0.67 [95% CI 0.51-0.89]).CONCLUSION:
In this analysis, IND/GLY reduced the risk of a CID in moderate COPD patients after direct switch from LABA + ICS or LABA or LAMA in real-life clinical practice.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Broncodilatadores
/
Quinolonas
/
Antagonistas Muscarínicos
/
Doença Pulmonar Obstrutiva Crônica
/
Agonistas de Receptores Adrenérgicos beta 2
/
Substituição de Medicamentos
/
Glicopirrolato
/
Indanos
/
Pulmão
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article