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(HealthDay) – A de-escalation of tritherapy to indacaterol / glycopyrronium may lead to a slight reduction in lung function in non-exacerbating patients frequently with chronic obstructive pulmonary disease (COPD), but no difference in exacerbation , according to a study published in the August 1 of American Journal of Respiratory and Critical Care Medicine.
Kenneth R. Chapman, MD, of the University of Toronto, and colleagues conducted a 26-week randomized trial to examine the direct switch from long-term triple therapy (tiotropium, salmeterol, fluticasone propionate) to 39, indacaterol / glycopyrronium or continued triple therapy in non-exacerbating patients who frequently have moderate to severe COPD. A total of 527 and 526 patients were randomized to receive indacaterol / glycopyrronium and triple therapy respectively.
The researchers found a reduction in forced expiratory volume per second of -26 ml (95% confidence interval, -53 to 1 ml) with withdrawal of inhaled corticosteroids, with confidence intervals exceeding the margin of -50 ml. . Between treatments, there was no difference in the annualized rate of moderate or severe COPD exacerbations (rate ratio, 1.08, 95% confidence interval, 0.83 to 1). 4). The loss of lung function was greater and the risk of exacerbation higher in patients with ≥ 300 blood eosinophils / μl initially. Both groups had similar side effects.
"The higher risk of exacerbation in patients with ≥300 blood eosinophils / μl suggests that these patients are likely to benefit from triple therapy," write the authors.
Several authors have revealed financial links with pharmaceutical companies, including Novartis Pharma, which funded the study.
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