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• W2140992701 abstract "Chronic obstructive pulmonary disease (COPD) is a difficult-to-treat condition with multiple outcomes with which to assess new drugs. Most treatments are symptomatic; none, at present, interfere with the natural history of the disease (except smoking cessation) and little is known about the factors able to predict a response. New anti-inflammatory agents able to modify the course of the disease may emerge, but further research is needed to assess their effects [1]. New drugs have to improve lung function and, most importantly, clinical outcomes with a demonstrated long-term safety at a reasonable cost. The crucial issues when combining bronchodilators are to investigate the magnitude of observed effects versus single agents and whether a “responding phenotype” can be identified. These questions are relevant for all the actors in the COPD field, from patients to health authorities, and will allow the definition of whether and how the new treatment approach will integrate with the current treatment guidelines.In this issue of the European Respiratory Journal , Bateman et al. [2] report results of the SHINE study, which assessed QVA149, an association of indacaterol, a long-acting β2-agonist (LABA) and glycopyrronium, a long-acting anticholinergic agent (LAMA), in a dry powder capsule device. This 26-week, large (n = 2144), randomised controlled trial (RCT) in patients with moderate-to-severe COPD compared QVA149 to its monocomponents, open-labelled tiotropium and placebo, all administered once daily. QVA149 improves dyspnoea and health-related quality of life, with statistically significant superiority over placebo and tiotropium, but not over its monocomponents. QVA149 was significantly more effective than its monocomponents, but not tiotropium in terms of lung function (as measured using trough forced expiratory volume in 1 s (FEV1)). These data extend results of RCTs evaluating QVA149 effect on lung function [3, 4], short-term (14 …" @default.
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• W2140992701 date "2013-11-30" @default.
• W2140992701 modified "2023-09-30" @default.
• W2140992701 title "Bronchodilator combinations for COPD: real hopes or a new Pandora’s box?" @default.
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• W2140992701 doi "https://doi.org/10.1183/09031936.00168313" @default.
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