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Combined bronchodilators (tiotropium plus olodaterol) for patients with chronic obstructive pulmonary disease

Authors Ramadan W, Kabbara W, El Khoury G, Al Assir S

Received 9 May 2015

Accepted for publication 6 August 2015

Published 30 October 2015 Volume 2015:10(1) Pages 2347—2356


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Professor Hsiao-Chi Chuang

Peer reviewer comments 4

Editor who approved publication: Dr Richard Russell

Wijdan H Ramadan,1 Wissam K Kabbara,1 Ghada M El Khoury,1 Sarah A Al Assir2

1Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon; 2School of Pharmacy, Lebanese American University, Byblos, Lebanon

Abstract: Chronic obstructive pulmonary disease (COPD), a respiratory disease characterized by a progressive decline in lung function, is considered to be a leading cause of morbidity and mortality. Long-acting inhaled bronchodilators, such as long-acting β2 agonists (LABAs) or long-acting muscarinic antagonists (LAMAs), are the cornerstone of maintenance therapy for patients with moderate-to-very-severe COPD. For patients not sufficiently controlled on a single long-acting bronchodilator, a combination of different bronchodilators has shown a significant increase in lung function. Tiotropium, a once-daily dosing LAMA, demonstrated sustained improvements in lung function as well as improved health-related quality of life, reduced exacerbations, and increased survival without altering the rate of decline in the mean forced expiratory volume in 1 second (FEV1) with fairly tolerable side effects. Olodaterol is a once-daily dosing LABA that has proven to be effective in improving lung function, reducing rescue medication use, and improving dyspnea and health-related quality of life, as well as improving exercise endurance with an acceptable safety profile. The combination of olodaterol and tiotropium provided additional improvements in lung function greater than monotherapy with each drug alone. Several well-designed randomized trials confirmed that the synergistic effect of both drugs in combination was able to improve lung function and health-related quality of life without a significant increase in adverse effects. The objective of this paper is to review available evidence on the clinical efficacy and safety of tiotropium, olodaterol, and their combination in patients with COPD.

Keywords: chronic obstructive pulmonary disease, bronchodilators, long-acting β2 agonists, long-acting muscarinic antagonist, olodaterol, tiotropium

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