Combo COPD Therapy Best for Older Adults
(HealthDay News) — A combination drug therapy of long-acting beta agonists and inhaled corticosteroids appears to be the best treatment for older adults with chronic obstructive pulmonary disease (COPD), especially those with asthma, according to a study published in the September 17 issue of the Journal of the American Medical Association.
The study involved government health data in Ontario on almost 12,000 people with COPD between 2003–2011, including 8,712 patients newly placed on the combination therapy of long-acting beta agonists and inhaled corticosteroids and 3,160 new users of long-acting beta agonists.
The researchers found that about 37.3% of people died while using beta agonists alone, compared with 36.4% of people using the combination therapy. Similar results occurred for hospitalizations caused by COPD. Overall, the use of combination therapy reduced risk of death or hospitalization by 3.7%, compared with beta agonists alone. The greatest difference was among COPD patients who had also been diagnosed with asthma. Overall, those on combination therapy had a 6.5% reduced risk of either death or hospitalization compared with those taking a single drug. The researchers noted, however, that the combination therapy appeared to be less effective for people using inhaled long-acting anticholinergic medication. Those who received the combination therapy and had never taken a long-acting anticholinergic had an 8.4% reduced risk of death or hospitalization.
The findings go against the official guidelines for treating COPD, but actually support what most chest physicians are doing in the clinic, lead author Andrea Gershon, MD, from the Sunnybrook Health Sciences Center and the Institute for Clinical Evaluative Sciences in Toronto, told HealthDay. "We found the combination therapy appeared to be more effective, and we found that a lot of people are being started on this combination therapy straight away."