In our October journal club we discussed the paper Comparative Effectiveness and Safety of Different Types of Inhaled Long-Acting β2-Agonist Plus Inhaled Long-Acting Muscarinic Antagonist vs Inhaled Long-Acting β2-Agonist Plus Inhaled Corticosteroid Fixed-Dose Combinations in COPD A Propensity Score-Inverse Probability of Treatment Weighting Cohort Study published in Chest journal. Here are Dr. Olga’s main takeaways.

There are a number of options of inhalational therapies available for treatment of COPD, however there is limited data on comparison of effectiveness of the various combination therapies.This retrospective study assessed the effects of dual inhalational therapy on reduction of acute COPD exacerbations and compared safety and effectiveness of different combinations of therapeutic agents in a large cohort of COPD patients. 

This paper attracted my attention as it added to the understanding of how different treatments would modify the course of the COPD disease. It provided additional evidence that both combinations of long-acting bronchodilators (LABA/LAMA) as well as inhaled corticosteroid and long acting bronchodilator (ICS/LABA) can effectively reduce the frequency of COPD exacerbations. There were no adverse effects on cardiovascular morbidity noted. 

The paper suggested that not all ICS/LABA combinations may be equal. The combinations typically found in Symbicort may be superior in their effects on COPD patients compared to combinations found in Advair or Wixela. This intriguing data requires further investigation in a dedicated randomized controlled studies. 

Overall I felt that this paper provided useful clinically applicable information, which helped to choose the best treatment for individual patients suffering from COPD. 

It is worth reading about!

For the article abstract, follow the link: https://journal.chestnet.org/article/S0012-3692(21)00952-1/fulltext