Efficacy and tolerability of budesonide/formoterol added to tiotropium compared with tiotropium alone in patients with severe or very severe COPD: A randomized, multicentre study in East Asia

@article{Lee2016EfficacyAT,
  title={Efficacy and tolerability of budesonide/formoterol added to tiotropium compared with tiotropium alone in patients with severe or very severe COPD: A randomized, multicentre study in East Asia},
  author={Sang-Do Lee and Can-Mao Xie and Faisal Yunus and Yohji Itoh and Xia Ling and Wai-Cho Yu and Sumalee Kiatboonsri},
  journal={Respirology},
  year={2016},
  volume={21}
}
Triple combination therapy with tiotropium plus budesonide/formoterol has improved lung function and reduced exacerbation risk in patients with chronic obstructive pulmonary disease (COPD) in Western countries, but no such data exist for East Asian patients. This study aimed to evaluate the efficacy and tolerability of adding budesonide/formoterol to tiotropium compared with tiotropium alone in East Asian patients with severe/very severe COPD. 
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In patients with COPD, treatment with extrafine BDP/FF/G improved bronchodilation, and was more effective at preventing moderate/severe COPD exacerbations than BUD/FF.
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There is consistent evidence that the LABA/LAMA/ICS combination has significantly greater effects on trough FEV1, symptoms, quality of life, and exercise performance compared to comparator treatments.
Treatment with inhaled corticosteroids in chronic obstructive pulmonary disease.
  • C. Janson
  • Medicine
    Journal of thoracic disease
  • 2020
TLDR
ICS together with LABA or LABA/LAMA reduces the risk of exacerbations in COPD and the indication of using ICS is stronger if the patient has increased blood eosinophils levels, with studies showing a better effect-safety profile with budesonide compared to fluticasone propionate.
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