Single-Inhaler Extra-Fine Triple Therapy Plus Education Improves COPD Outcomes
Researchers publishing in Respiratory Medicine have found that COPD patients who switched from dual- or multiple-inhaler therapy to single-inhaler extra-fine triple therapy and were educated on the correct way to use the inhaler experienced multiple improvements.
The study was conducted among 126 patients with moderate-to-severe COPD. The extra-fine triple therapy consisted of beclomethasone dipropionate, 87 µg, formoterol fumarate, 5 µg, and glycopyrronium, 9 µg, two inhalations twice a day. All the participants underwent inhalation therapy training.
Participants were assessed for inhalation technique at baseline and then again at two additional visits 1-5 months and 5-13 months later. The authors found –
- Device errors were detected among 28.8% of patients and critical errors were detected among 9.6% of patients at the baseline visit.
- Device errors decreased to 14% of patients at the second visit, with zero critical errors noted.
- At the third visit, 16.3% of patients had device errors, zero critical errors were noted, and the inhalation technique had improved.
- Treatment adherence increased from 67.5% at baseline to 75.8% at the second visit and 80% at the third visit.
- A significant decrease in exacerbation rates and increased lung function, symptom, and patient satisfaction scores were associated with the enhanced inhalation technique.
The investigators believe these findings suggest COPD patients can benefit from switching to single-inhaler extra-fine triple therapy combined with inhaler education. Read More
COPD Admissions on the Rise
Are admissions for COPD going up? According to Canadian researchers, the answer may be yes. After adjusting for other factors, they found a nearly 10% increase in hospital admissions for COPD patients in their country since 2002, with women and people younger than 65 most affected.
The study examined national data on hospital admissions in Canada, identifying 1,134,359 admissions for COPD in patients aged 40 years and older between 2002 and 2017. Overall, 21.2% of the admissions were among adults between the ages of 40 and 64, and in this age group, more than half were women.
Overall, COPD admissions rose by 68.8% during the 16 years of the study and remained at nearly 10%, going from 437 to 479 per 100,000 people, after adjusting for population growth, age, and sex. The increase was most pronounced in younger women, younger men, and older women, who saw rises of 12.2%, 24.4%, and 29.8%, respectively. Admissions for older men fell 9%.
The authors note this increase was seen at a time when admissions for other conditions were on the decline, leading them to question whether care for COPD patients is really improving.
The study was published by the Canadian Medical Association Journal. Read More
A Phase I clinical trial conducted in China offers hope that COPD patients may one day be treated using their own stem cells.
According to the investigators, the 17 patients in their study who received the experimental treatment had better lung function after the treatment and were able to walk farther during the six minute walk test.
In two patients with emphysema, the treatment appeared to repair lung damage caused by the disease as well.
The treatment involved taking P63+ progenitor cells from the lungs using a tiny catheter containing a brush to collect the cells. The scientists used those cells to clone millions more in the laboratory and then transplanted them back into the patients’ lungs via bronchoscopy.
The treatment was well tolerated by the patients, and by a 12 week follow up, the median DLCO had increased from 30% to 39.7%. DLCO further increased to 40.3% at the 24 week follow up.
The median distance covered during the six minute walk test increased from 410 meters prior to treatment to 447 meters at 24 weeks and scores on the St. George’s Respiratory Questionnaire improved by seven points.
Symptoms such as shortness of breath, loss of exercise ability, and persistent coughing improved after the treatment as well.
The investigators are now planning a Phase II trial aimed at evaluating the treatment in a larger group of patients. The treatment is being tested in people with idiopathic pulmonary fibrosis and other lung fibrotic diseases too, and the researchers want to test it in other and larger groups of people with lung conditions as well. They hope to have it ready for clinical use within the next two or three years.
The study was presented at the recent European Respiratory Society conference. Read More