Introduction: Bronchodilators are the cornerstone of chronic obstructive pulmonary disease (COPD) therapy and long-acting muscarinic antagonists (LAMAs) as a mono or combination treatment play a pivotal role. Several LAMAs are already available on the market in different formulations, but developing a new compound with a higher M3 receptor selectivity and a lower affinity to M2 receptors to increase the therapeutic effect and minimize the adverse effects is still a goal. Moreover, new formulations could improve adherence to therapy.
Areas Covered: This systematic review assesses investigational long-acting muscarinic antagonist in Phase I and II clinical trials over the last decade. It offers insights on whether LAMAs and/or their new formulations in clinical development can become effective treatments for COPD in the future.
Expert Opinion: Research on LAMA seems to have come to a standstill, the few new molecules under study do not show distinctive characteristics compared to the previous ones. Muscarinic antagonist/β2-agonist (MABAs) appear to be the major innovation currently under investigation, and they could theoretically open new research frontiers on the effect between adrenergic and muscarinic interaction in the same cell.
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http://dx.doi.org/10.2147/JEP.S259330 | DOI Listing |
J Family Med Prim Care
December 2024
Medicines Evaluation Unit, Manchester University National Health Service Foundation Trust, University of Manchester, Manchester, United Kingdom.
Context: An inhaled corticosteroid (ICS) in combination with a long-acting β2-agonist (LABA) is a common treatment approach for asthma patients not controlled on ICS alone, but a significant proportion of patients remain uncontrolled on this combination and treatment adherence can also be a challenge. One of the options for adults whose asthma is uncontrolled in an ICS/LABA is the addition of a long-acting muscarinic receptor antagonist (LAMA), an approach commonly referred to as 'triple therapy'. The use of medium-strength ICS/LABA/LAMA is established in treating chronic obstructive pulmonary disease but is less well-established in asthma.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
China has implemented the "tiered medical services" policy since 2015, while there is a paucity of data evaluating the the current status of chronic obstructive pulmonary disease (COPD) management under the system. Characteristics and treatments from 11,905 COPD patients in 88 hospitals across different tiers in China were included and analyzed. We assessed the statistical significance of differences by one way analysis of variance (ANOVA) for continuous variables and with the chi-squared test for categorical variables.
View Article and Find Full Text PDFHeart Lung
January 2025
Adelson School of Medicine, Ariel University, 3 Kiryat Hamada St., Ariel, Israel; Pulmonary Clinic, Dan- Petah-Tiqwa District, Clalit Health Services Community Division, 25 Hamytar St., Ramat-Gan, Israel. Electronic address:
Background: Confounding reports of cardiovascular disease (CVD) with the use of Inhaled corticosteroids (ICS), long-acting beta-agonists, and muscarinic antagonists (LABA and LAMA) have been reported.
Objective: To explore the relationship between the purchase of ICS, LABA and LAMA inhalers and the incidence of CVDs.
Methods: This retrospective study included patients with COPD and/or asthma, aged ≥ 18 years, who purchased LABA, LAMA, and ICS inhalers alone or in combination between 2017 and 2019.
Pulm Ther
January 2025
MSc Program in Sleep Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) in the same patient is referred to as overlap syndrome (OS). Patients with OS suffer more frequently from cardiovascular disease (CVD) and carry a higher risk of COPD-related exacerbations than patients with COPD alone, especially when OSA is left untreated. Based on recent evidence, triple therapy, namely inhaled corticosteroid/long-acting muscarinic antagonist/long-acting beta-agonist (ICS-LABA-LAMA), is a treatment strategy in COPD patients with a history of exacerbations and/or CVD comorbidity.
View Article and Find Full Text PDFExpert Rev Respir Med
December 2024
Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.
Background: Two long-acting muscarinic antagonist inhaler fixed dose combinations (olodaterol/tiotropium (OLO/TIO) and vilanterol/umeclidinium (VI/UMEC)) have once-a-day dosing for managing chronic obstructive pulmonary disease (COPD). This study aimed to compare clinical effectiveness of these inhalers in terms of ability to prevent severe COPD exacerbations in a United States Medicare population.
Research Design And Methods: Using nationally representative Medicare data (2013-2019), we employed a new user, active comparator design among beneficiaries aged 65 years and older with COPD.
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