Improved Combination Therapy Works Better for COPD Exacerbations, Study Says

New research led by Wisia Wedzicha, a professor of respiratory medicine at England’s National Heart and Lung Institute (NHLI), reports an improved combination therapy for the treatment of chronic obstructive pulmonary disease (COPD) exacerbations.

The study’s findings were published in the New England Journal of Medicine, titled “Indacaterol–Glycopyrronium versus Salmeterol–Fluticasone for COPD.”

COPD patients commonly suffer from exacerbation episodes where a sudden worsening of symptoms can end up in the hospital. These exacerbations can be triggered by infection or air pollutants. The only way to fight them is by trying to manage their frequency and ultimately reduce their occurrence, either with inhaled corticosteroids (ICS), with long-acting Beta 2 agonists (LABA), or with inhaled long-acting muscarinic antagonists (LAMA).

Wedzicha’s research study was the first to compare two combination therapies to treat COPD patients at risk of exacerbation: two bronchodilators combining indacaterol/glycopyrronium (LABA/LAMA) compared to the standard therapy, a combination of salmeterol and fluticasone (ICS/LABA).

According to a news release, results showed that the combination LABA/LAMA was superior to the current standard treatment (ICS/LABA) recommended for the entire spectrum of exacerbation symptoms, with a promising safety profile and fewer records of pneumonia episodes.

The trial’s results will have significant implications for COPD patients and treatment algorithms, and researchers advise that all COPD guidelines should be revised. The outcomes of the study should influence the quality of healthcare and the quality of life for COPD patients.

Novartis sponsored the trial included in this study, of which Wedzicha was the principal investigator.

Wedzicha chairs the Department of Respiratory Medicine at Imperial College in London and was elected as a Fellow of the Academy of Medical Sciences (FMedSCi) in 2013. She is also an NIHR senior investigator. Wedzicha is the editor-in-chief for the American Journal of Respiratory and Critical Care Medicine journal and served as the Lancet ombudsman until 2014.

Wedzicha has extensive experience in studying the causes, mechanisms, impact, and prevention of COPD exacerbations, as well as the role of bacterial and viral infections in these exacerbations. At Imperial College, she directs an active research group specializing in COPD and has published several academic and scientific articles on the topic.