TY - JOUR
T1 - The reasons for triple therapy in stable COPD patients in Japanese clinical practice
AU - Keio COPD Comorbidity Research (K-CCR) group
AU - Miyazaki, Masaki
AU - Nakamura, Hidetoshi
AU - Takahashi, Saeko
AU - Chubachi, Shotaro
AU - Sasaki, Mamoru
AU - Haraguchi, Mizuha
AU - Terai, Hideki
AU - Ishii, Makoto
AU - Fukunaga, Koichi
AU - Tasaka, Sadatomo
AU - Soejima, Kenzo
AU - Asano, Koichiro
AU - Betsuyaku, Tomoko
N1 - Publisher Copyright:
© 2015 Miyazaki et al.
PY - 2015/6/4
Y1 - 2015/6/4
N2 - Background: Triple combination therapy involving long-acting muscarinic antagonists long-acting β2 agonists, and inhaled corticosteroids has recently become an option for maintenance treatment of COPD. Some add-on clinical trials have reported the benefits of these combinations. However, the process to step up to triple therapy varies for individual cases. Methods: Keio University and affiliated hospitals conducted an observational COPD cohort study, recruiting patients diagnosed as having COPD by pulmonary physicians and those referred for investigation of possible COPD. Their prescription history and clinical course were retrospectively analyzed based on the physicians’ medical records and patient questionnaires. This study was registered with UMIN (UMIN000003470, April 10, 2010). Results: A total of 95 of the 445 COPD patients (21%) were treated with inhaled corticosteroids/long-acting β2 agonists/long-acting muscarinic antagonists as maintenance therapy, including 12 in COPD Grade I, 31 in Grade II, 38 in Grade III, and 14 in Grade IV, based on the Global Initiative for Chronic Obstructive Lung Disease spirometric grading. For more than half of the patients on triple therapy, the treatment had been intensified due to unsatisfactory improvement of symptoms, and 32% were treated with triple therapy due to comorbid asthma. In contrast, there were COPD patients whose therapy was maintained after starting with triple therapy because of their serious conditions or concurrent exacerbation at diagnosis (8%). Conclusion: Triple therapy was often prescribed in the real-life management of COPD, even in patients whose airflow limitation was not severe. To better control symptoms was the major reason for choosing triple therapy, regardless of the severity of COPD, in Japan.
AB - Background: Triple combination therapy involving long-acting muscarinic antagonists long-acting β2 agonists, and inhaled corticosteroids has recently become an option for maintenance treatment of COPD. Some add-on clinical trials have reported the benefits of these combinations. However, the process to step up to triple therapy varies for individual cases. Methods: Keio University and affiliated hospitals conducted an observational COPD cohort study, recruiting patients diagnosed as having COPD by pulmonary physicians and those referred for investigation of possible COPD. Their prescription history and clinical course were retrospectively analyzed based on the physicians’ medical records and patient questionnaires. This study was registered with UMIN (UMIN000003470, April 10, 2010). Results: A total of 95 of the 445 COPD patients (21%) were treated with inhaled corticosteroids/long-acting β2 agonists/long-acting muscarinic antagonists as maintenance therapy, including 12 in COPD Grade I, 31 in Grade II, 38 in Grade III, and 14 in Grade IV, based on the Global Initiative for Chronic Obstructive Lung Disease spirometric grading. For more than half of the patients on triple therapy, the treatment had been intensified due to unsatisfactory improvement of symptoms, and 32% were treated with triple therapy due to comorbid asthma. In contrast, there were COPD patients whose therapy was maintained after starting with triple therapy because of their serious conditions or concurrent exacerbation at diagnosis (8%). Conclusion: Triple therapy was often prescribed in the real-life management of COPD, even in patients whose airflow limitation was not severe. To better control symptoms was the major reason for choosing triple therapy, regardless of the severity of COPD, in Japan.
KW - Chronic obstructive pulmonary disease
KW - Inhaled corticosteroids
KW - Long-acting muscarinic antagonists
KW - Long-acting β agonists
KW - Triple therapy
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U2 - 10.2147/COPD.S79864
DO - 10.2147/COPD.S79864
M3 - Article
C2 - 26082629
AN - SCOPUS:84933574007
VL - 10
SP - 1053
EP - 1059
JO - International Journal of COPD
JF - International Journal of COPD
SN - 1176-9106
ER -