Download PDF
Dtsch Med Wochenschr 2021; 146(07): 471-473
DOI: 10.1055/a-1219-0708
Klinischer Fortschritt
Pneumologie

Inhalative Therapie der COPD – alle Patienten auf „fixed triple“?

Inhaled therapies in COPD – all patients on fixed triple?
Henrik Watz
  Pneumologisches Forschungsinstitut an der LungenClinic Großhansdorf, Airway Research Center North (ARCN), Deutsches Zentrum für Lungenforschung (DZL), Großhansdorf
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Was ist neu?

Neue Studien mit „fixed triple“ Die 3 großen randomisierten, doppelblinden Phase-III-Studien TRIBUTE, IMPACT und ETHOS untersuchten den Stellenwert der 3-Fach-Fixkombination aus langwirksamen Beta-2-Sympathomimetika, langwirksamen Muskarinantagonisten und inhalativen Kortikosteroiden (LABA, LAMA, ICS) gegenüber den 2-Fachkombinationen (ICS/LABA oder LABA/LAMA). Die 3 Studien rekrutierten Patienten, bei denen Exazerbationen in den letzten 12 Monaten vor Studieneinschluss aufgetreten waren.

Abstract

Inhaled maintenance therapies in chronic obstructive pulmonary disease (COPD) are based on bronchodilators and inhaled corticosteroids (ICS). Inhaled bronchodilator therapies consist of long-acting beta-2 agonists (LABA) and long-acting muscarinic antagonists (LAMA). LABA or LAMA treatment is recommended in symptomatic COPD patients. In case of a history of exacerbations LAMA is superior to LABA in the prevention of exacerbations. LABA LAMA combination therapies are used in patients who are highly symptomatic. Adding ICS to bronchodilator treatment is recommended in COPD patients with repeated exacerbations. Recently, fixed triple therapies consisting of LABA, LAMA and ICS in single inhalers became available.

Schlüsselwörter

chronisch obstruktive Bronchitis und Lungenemphysem - Dauertherapie - 3-Fach-Fixkombination

Key words

chronic obstructive pulmonary disease - maintenance treatment - fixed-dose combination triple therapy


Publication History

Article published online:
29 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Watz H, Kirsten A, Greulich T. Stufentherapie der COPD. Dtsch Med Wochenschr 2019; 144: 15-20 . doi:10.1055/a-0570-3595
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Vogelmeier C, Buhl R, Burghuber O. et al Leitlinie zur Diagnostik und Therapie von Patienten mit chronisch obstruktiver Bronchitis und Lungenemphysem (COPD). Pneumologie 2018; 72: 253-308 . doi: 0.1055/s-0043-125031
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Papi A, Vestbo J, Fabbri L. et al Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial. Lancet 2018; 391: 1076-1084 . doi:10.1016/S0140-6736(18)30206-X
    CrossrefPubMedGoogle Scholar
  • 4 Lipson DA, Barnhart F, Brealey N. et al Once-Daily Single-Inhaler Triple versus Dual Therapy in Patients with COPD. N Engl J Med 2018; 378: 1671-1680 . doi:10.1056/NEJMoa1713901
    CrossrefPubMedGoogle Scholar
  • 5 Rabe KF, Martinez FJ, Ferguson GT. et al Triple Inhaled Therapy at Two Glucocorticoid Doses in Moderate-to-Very-Severe COPD. N Engl J Med 2020; 383: 35-48 . doi:10.1056/NEJMoa1916046
    CrossrefPubMedGoogle Scholar