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Obstructive Lung Diseases |

Analysis of Chronic Obstructive Pulmonary Disease Exacerbations With the Triple Therapy Compared With Dual and Single Bronchodilator Therapy: Which Treatment Is Better for Patients With Severe Disease?

Alizamin Sadigov, MD; Sakhavatdin Akhundov, PhD; Rovshan Bagirov, DO
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Medical University, Baku, Azerbaijan


Chest. 2014;145(3_MeetingAbstracts):425A. doi:10.1378/chest.1834832
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Abstract

SESSION TITLE: COPD I

SESSION TYPE: Slide Presentations

PRESENTED ON: Sunday, March 23, 2014 at 04:15 PM - 05:15 PM

PURPOSE: The purpose of this study was to evaluated the effect of triple-combined long acting inhaled bronchodilator treatment with roflumilast and dual-combined long acting inhaled bronchodilator and single-long acting inhaled bronchodilator treatment on exacerbations in patients with severe and very severe chronic obstructive pulmonary disease(COPD).

METHODS: In this parallel- group study,228 patients(aged>years,Global Initiative for Chronic Obstructive Lung disease stages III-IV,and one or more moderate to severe COPD exacerbation in the past year)were randomly assigned(1:1:1:1;via interactive voice response;stratied for smoking status)to once daily triple(indacaterol at dose 300 mcg combined with tiotropium 18 mcg and roflumilast 500 mcg),dual(indacaterol 300 mcg combined with tiotropium 18 mcg),and single(indacaterol 300 mcg and tiotropium 18 mcg in separate group patients) therapy for 52 weeks.Assignment to triple,dual and single therapy was open -label.

RESULTS: Our study shown that indacaterol combined with tiotropium and roflumilast markedly reduced the risk of moderate to severe exacerbations of COPD vs indacaterol combined tiotropium by 15%,vs indacaterol by 25%,vs tiotropium 23%.Incidence of serious adverse events was similar between groups(11[19%] patients on triple,10[18%] on dual,9[16%] on indacaterol,9[16%] on tiotripium);COPD worsening was the most frequent seious adverse event(2[3.5%] patients on triple,3[5.3%] on dual,4[7%] on indacaterol and 4[7%] on tiotropium).

CONCLUSIONS: The triple therapy including indacaterol combined with tiotropium and roflumilast was superior in preventing moderate to severe COPD exacerbations compared with dual long acting inhaled bronchodilator therapy,with concominant improvements in lung function and health status.

CLINICAL IMPLICATIONS: Our investigation suggested that in patients with severe and very severe COPD with history of chronic bronchitis and frequent exacerbations triple therapy might used as treatment option.

DISCLOSURE: The following authors have nothing to disclose: Alizamin Sadigov, Sakhavatdin Akhundov, Rovshan Bagirov

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