Antonio Anzueto, MD, on Single-Inhaler Triple Therapy Improves Lung Function In COPD

In this video, Antonio Anzueto, MD, talks about the findings and clinical impacts of his team's study that compared fluticasone furoate/umeclidinium/vilanterol in a single inhaler with tiotropium among patients with symptomatic COPD, who are at risk of exacerbations.

Additional Resource:

• Anzueto A, Obeid D, Bansal S, et al. Single-inhaler triple therapy fluticasone furoate/umeclidinium/vilanterol compared with tiotropium monotherapy in COPD: a post-hoc analysis by airflow. Paper presented at: CHEST Annual Meeting 2020; October 18-21, 2020; Virtual. https://journal.chestnet.org/article/S0012-3692(20)33702-8/fulltext 

Antonio R. Anzueto, MD, is a professor of medicine in the Division of Pulmonary Diseases at the University of Texas, San Antonio, and the chief of the Pulmonary Section at the South Texas Veterans Health Care System.

TRANSCRIPT:

My name is Antonio Anzueto. I’m a professor of medicine at the University of Texas, San Antonio. I'm also the section chief for pulmonary at the South Texas Veterans Health Care System.

So the translation into clinical practice of these findings is something that is very important. It comes down to the issue of “Who are the patients who need to have inhaled corticosteroids as part of the pharmacotherapy?”

And in this study, we enrolled patients who have history of exacerbations. We know that the patients who either have been hospitalized because they have a COPD exacerbation or have a history of exacerbation. These patients are the ones that inhaled corticosteroids have to be part of their pharmacotherapy.

What is happening now is with a single inhaler, we can provide a protection for and the improvement in lung function with the 2 bronchodilators. With a single inhaler with one inhalation, the patient can receive all the pharmacotherapy that is needed to maintain the lung function and to prevent these events that we call exacerbations.

Furthermore, if the patient happens to have elevated eosinophils, that would be another marker that they need to have inhaled corticosteroids. So, having been hospitalized with exacerbations and high eosinophils, those individuals are more likely to respond much better to these medications.

I'm demonstrating that the efficacy was better compared with tiotropium, so tiotropium should be used as initial therapy in patients who have been newly diagnosed and asymptomatic; they haven’t had exacerbations. But in the patients who’ve had exacerbations, they’re symptomatic, triple therapy would be the best alternative for them.

I hope I have provided you with useful information to your practice. And, remember, make a diagnosis because if you can treat that condition, you can significant impact the patient's life. Thank you.