New light shed on improving treatment for COPD exacerbations

Research by Professor Wedzicha of the National Heart and Lung Institute (NHLI) finds better combination therapy for treating COPD exacerbations.

It is thought that there are nearly 3 million people in the UK who suffer with chronic obstructive pulmonary disorder, more commonly called COPD. Patients with COPD are often afflicted by exacerbations where they see a sudden worsening of their symptons, such as breathlessness, potentially triggered by an infection or air pollutants.  To combat this, patients are placed on treatment plans to try to manage the frequency of these recurrences and ultimately reduce their occurrence.

Currently there are two options recommended for prevention of COPD. Either inhaled corticosteroids (ICS) with long acting Beta 2 agonists (LABA), or an inhaled long-acting muscarinic anatagonist (LAMA). To date a combination of the two regimes had not been compared to find the best results for patients.

New research by Professor Wedzicha of the National Heart and Lung Institute is the first study to compare two combination therapies to treat COPD patients at risk of exacerbations. Comparing two bronchodilators combined (LABA/LAMA) to the standard therapy, that uses a combination of a long acting beta agonist and inhaled corticosteroid – Salmeterol and Fluticasone (ICS/LABA). Findings from the study were published in the New England journal of Medicine earlier this year.

The trial showed that Indacaterol/glycopyrronium (LABA/LAMA) was superior to the current recommended treatment for the whole spectrum of exacerbation symptoms tested, with a good safety profile and less episodes of pneumonia. Professor Wedzicha was the PI for the trial and it was sponsored by Novartis. 

COPD exacerbations play an important role in COPD management as they affect disease progression, hospital admissions and are costly to healthcare services.  The assessment of COPD exacerbations during the trial involved the methodology developed by Prof Wedzicha and her research team and used in the London COPD exacerbation cohort based at Imperial College.

The results of this trial will now have major implications for COPD patients and treatment algorithms in guidelines will need to be revised. This should help improve the healthcare and quality of life for COPD patients.

Image used under Creative Commons license Credit: UMHealthSystem