Preview

Meditsinskiy sovet = Medical Council

Advanced search

Clinical experience of using formoterol/budesonide in patients with chronic obstructive pulmonary disease

https://doi.org/10.21518/2079-701X-2021-16-26-31

Abstract

Chronic obstructive pulmonary disease (COPD) today remains one of the most important problems of modern medicine. The social significance of this disease is determined by the annual health care costs for treating patients with exacerbated COPD, as well as the still high mortality and disability rates worldwide. The main goals of COPD treatment are to slow the rate of disease progression, control the symptoms, reduce the frequency of exacerbations and hospitalizations, and reduce the risk of future exacerbations. Currently, the main groups of drugs for basic therapy of COPD are inhaled prolonged bronchodilators from the groups of β2-adrenergic agonists and M-anticholinergics, as well as their combinations. Patients with COPD and bronchial asthma, as well as patients with COPD with elevated levels of eosinophils and frequent exacerbations, inhaled glucocorticosteroids (ICS) are used. It has been proven that the addition of corticosteroids to LABA in patients with moderate to severe COPD and frequent exacerbations has a more effective influence on pulmonary function and the number of exacerbations. Clinical studies have shown the relationship between the level of blood eosinophilia and the clinical effects of preventing future exacerbations when using iCS in combination with LABA. In our clinical observation, in patient with moderate COPD and blood eosinophilia > 300 cells/μL, when prescribing monotherapy with long-acting agonists, frequent exacerbations of the disease were noted. The addition of corticosteroids to monotherapy with a long-acting agonist made it possible to influence the frequency of exacerbations and reduce the level of eosinophils in the blood.

About the Authors

I. V. Demko
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Krasnoyarsk Clinical Regional Hospital
Russian Federation

Irina V. Demko, Dr. Sci. (Med.), Professor, Head of Department of Hospital therapy and Immunology with Postgraduate Education Course; Head of Pulmonary Allergology Сenter

1, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia

3a, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia



M. G. Mamaeva
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Krasnoyarsk Clinical Regional Hospital
Russian Federation

Marina G. Mamaeva, Cand. Sci. (Med.), Assistant of the Department of Hospital Therapy and Immunology with Postgraduate Education Course; Pulmonologist

1, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia

3a, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia



E. A. Sobko
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Krasnoyarsk Clinical Regional Hospital
Russian Federation

Elena A. Sobko, Dr. Sci. (Med.), Professor of Department of Hospital Therapy and Immunology with Postgraduate Education Course; Head of Department of Allergology

1, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia

3a, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia



A. Yu. Kraposhina
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Krasnoyarsk Clinical Regional Hospital
Russian Federation

Angelina Yu. Kraposhina, Cand. Sci. (Med.), Associate Professor of Department of Hospital Therapy and Immunology with Postgraduate Education Course; Pulmonologist

1, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia

3a, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia



N. V. Gordeeva
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Krasnoyarsk Clinical Regional Hospital
Russian Federation

Natalia V. Gordeeva, Cand. Sci. (Med.), Associate Professor of Department of Hospital Therapy and Immunology with Postgraduate Education Course; Pulmonologist

1, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia

3a, Partizan Zeleznyak St., Krasnoyarsk, 660022, Russia



References

1. Ajsanov Z.R., Avdeev S.N., Arhipov V.V., Belevskij A.S., Leshchenko I.V., Ovcharenko S.I. et al. National clinical guidelines on diagnosis and treatment of chronic obstructive pulmonary disease: a clinical decision-making algorithm. Pulmonologiya = Russian Pulmonology. 2017;27(1):13–20. (In Russ.) https://doi.org/10.18093/0869-0189-2017-27-1-13-20.

2. Chuchalin A., Khaltaev N., Antonov N., Galkin D., Manakov L., Antonini P. et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int J Chron Obstruct Pulmon Dis. 2014;9(1):963–974. https://doi.org/10.2147/COPD.S67283.

3. Koncevaya A.V., Mukaneeva D.K., Balanova Yu.A., Hudyakov M.B., Drapkina O.M. Economic burden of respiratory diseases and chronic obstructive pulmonary disease in Russian Federation, 2016. Pulmonologiya = Russian Pulmonology. 2019;29(2):159–166. (In Russ.) https://doi.org/10.18093/0869-0189-2019-29-2-159-166.

4. Chuchalin A.G., Avdeev S.N., Ajsanov Z.R., Belevskij A.S., Leshchenko I.V., Meshcheryakova N.N. et al. Russian respiratory society. Federal guidelines on diagnosis and treatment of chronic obstructive pulmonary disease. Pulmonologiya = Russian Pulmonology. 2014;(3):15–54. (In Russ.) https://doi.org/10.18093/0869-0189-2014-0-3-15-54.

5. Avdeev S.N. Prevention of acute exacerbations of chronic obstructive pulmonary disease. Pulmonologiya = Russian Pulmonology. 2016;26(5):591–603. (In Russ.) https://doi.org/10.18093/0869-0189-2016-26-5-591-603.

6. Lange P., Halpin D.M., O’Donnell D.E., MacNee W. Diagnosis, assessment, and phenotyping of COPD: beyond FEV₁. Int J Chron Obstruct Pulmon Dis. 2016;11(Spec Iss):3—12. https://doi.org/10.2147/COPD.S85976.

7. Burgel P.R. Des définitions aux phénotypes de BPCO. From COPD definitions to COPD phenotypes. Presse Med. 2014;43(12):1337—1343. https://doi.org/10.1016/j.lpm.2014.09.004.

8. Albert P., Agusti A., Edwards L., Tal-Singer R., Yates J., Bakke P. et al. Bronchodilator responsiveness as a phenotypic characteristic of established chronic obstructive pulmonary disease. Thorax. 2012;67(8):701–708. https://doi.org/10.1136/thoraxjnl-2011-201458.

9. Vizel A.A., Vizel I.Yu., Bakunina E.A. Chronic obstructive pulmonary disease. Modern approaches to therapy. Meditsinskiy sovet = Medical Council. 2016;(15):6–10. (In Russ.) https://doi.org/10.21518/2079-701X-2016-15-6-10.

10. Ovakimyan K.V., Pahaznikova M.A., Andreeva E.A., Kuznecova O.Yu., Plavinskij S.L. Diagnostic algorithm for detecting chronic obstructive pulmonary disease in primary care. Vestnik Severo-Zapadnogo gosudarstvennogo medicinskogo universiteta im. I.I. Mechnikova = Herald of North-Western State Medical University named I.I. Mechnikov. 2018;10(2):44–51. (In Russ.) https://doi.org/10.17816/mechnikov201810244-51.

11. Vizel A.A., Vizel I.Yu., Amirov N.B. Chronic obstructive pulmonary disease (COPD). Change as a cause for discussion. Vestnik sovremennoj klinicheskoj mediciny = The Bulletin of Contemporary clinical Medicine. 2015;8(1):62—69. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=22933612.

12. Ovcharenko S.I., Vizel A.A., Gamova I.V., Dobrotina I.S., Zhestkov A.V., Postnikova L.B. et al. The relevance of the use of questionnaires for doctors and patients with chronic obstructive pulmonary disease for the purpose of early detection of exacerbations (conclusion of the Council of Experts of the Volga, Central and Southern Federal Districts of Russia). Vestnik sovremennoj klinicheskoj mediciny = The Bulletin of Contemporary Clinical Medicine. 2017;10(5):79–89. (In Russ.) https://doi.org/10.20969/VSKM.2017.10(5).79-89.

13. Sviderskaya L.N., Simakova V.M., Demko I.V., Hendogina V.T., Kudryavceva A.N., Tret’yak T.V. et al. Comparative analysis of organising the control at availability and quality of health care in regional consultative polyclinic. Sibirskoe medicinskoe obozrenie = Siberian Medical Review.2016;(5):53–64. (In Russ.) Available at: https://smr.krasgmu.ru/journal/1629_53.pdf.

14. Demko I.V., Gordeeva N.V., Kraposhina A.Yu., Mamaeva M.G., Solov’eva I.A. Experience of using double bronchodilation therapy in patients with COPD. Meditsinskiy sovet = Medical Council. 2020;(21):90–95. (In Russ.) https://doi.org/10.21518/2079-701X-2020-21-90-95.

15. Agusti A., Edwards L.D., Rennard S.I., MacNee W., Tal-Singer R., Miller B.E. et al. Persistent Systemic Inflammation is Associated with Poor Clinical Outcomes in COPD: A Novel Phenotype. PLoS ONE. 2012;7(5):e37483. https://doi.org/10.1371/journal.pone.0037483.

16. King P. Inflammation in chronic obstructive pulmonary disease and its role in cardiovascular disease and lung cancer. Clin Transl Med. 2015;4(1):26. https://doi.org/10.1186/s40169-015-0068-z.

17. Emel’yanov A.V., Leshenkova E.V., Sergeeva G.R. Inhaled glucocorticosteroids in the treatment of chronic obstructive pulmonary disease: the debate continues. Farmateka. 2019;26(5):10–16. (In Russ.) https://doi.org/10.18565/pharmateca.2019.5.10-16.

18. Latorre M., Novelli F., Vagaggini B., Braido F., Papi A., Sanduzzi A. et al. Differences in the efficacy and safety among inhaled corticosteroids (ICS)/ long-acting beta2-agonists (LABA) combinations in the treatment of chronic obstructive pulmonary disease (COPD): Role of ICS. Pulm Pharmacol Ther. 2015;30:44–50. https://doi.org/10.1016/j.pupt.2014.10.006.

19. Zykov K.A., Ovcharenko S.I. Approaches to drug therapy in patients with stable COPD: suggested treatment algorithm. Meditsinskiy sovet = Medical Council. 2015;(17):24–31. (In Russ.) Available at: https://www.med-sovet.pro/jour/article/view/422.

20. Nannini L.J., Poole P., Milan S.J., Kesterton A. Combined corticosteroid and long-acting beta(2)-agonist in one inhaler versus inhaled corticosteroids alone for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2013;(8):CD006826. https://doi.org/10.1002/14651858.CD006826.

21. Spencer S., Evans D.J., Karner C., Cates C.J. Inhaled corticosteroids versus long-acting beta(2)-agonists for chronic obstructive pulmonary disease.Cochrane Database Syst Rev.2011;(10):CD007033. https://doi.org/10.1002/14651858.CD007033.

22. Suissa S., Patenaude V., Lapi F., Ernst P. Inhaled corticosteroids in COPD and the risk of serious pneumonia. Thorax. 2013;68(11):1029–1036. https://doi.org/10.1136/thoraxjnl-2012-202872.

23. Suissa S., Coulombe J., Ernst P. Discontinuation of Inhaled Corticosteroids in COPD and the Risk Reduction of Pneumonia. Chest. 2015;148(5):1177–1183. https://doi.org/10.1378/chest.15-0627.

24. Brusselle G., Pavord I.D., Landis S., Pascoe S., Lettis S., Morjaria N. et al. Blood eosinophil levels as a biomarker in COPD. Respir Med. 2018;138:21–31. https://doi.org/10.1016/j.rmed.2018.03.016.

25. Calverley P.M.A. A Light in the Darkness? The FLAME Trial, Blood Eosinophils, and Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2017;195(9):1125–1127. https://doi.org/10.1164/rccm.201703-0560ED.

26. Yilmaz I., Turk M. What Should Be the Cutoff Value of Blood Eosinophilia as a Predictor of Inhaled Corticosteroid Responsiveness in Patients with Chronic Obstructive Pulmonary Disease? Am J Respir Crit Care Med. 2017;196(9):1229–1230. https://doi.org/10.1164/rccm.201705-0892LE.

27. Sharafkhaneh A., Southard J.G., Goldman M., Uryniak T., Martin U.J. Effect of budesonide/formoterol pMDI on COPD exacerbations: a double-blind, randomized study. Respir Med. 2012;106(2):257–268. https://doi.org/10.1016/j.rmed.2011.07.020.

28. Scott L.J. Budesonide/formoterol Turbuhaler®: a review of its use in chronic obstructive pulmonary disease. Drugs. 2012;72(3):395–414. https://doi.org/10.2165/11208460-000000000-00000.

29. Ovcharenko S.I., Vizel A.A., Gamova I.V., Dobrotina I.S., Zagidullin Sh.Z., Kupaev V.I. et al. A role of budesonide/formoterol fixed combination in the treatment of stable chronic obstructive pulmonary disease. A conclusion of the Expert Council of the Volga Federal district of Russia. Pulmonologiya = Russian Pulmonology. 2017;27(1):114–121. (In Russ.) https://doi.org/10.18093/0869-0189-2017-27-1-114-121.

30. Ferguson G.T., Tashkin D.P., Skärby T., Jorup C., Sandin K., Greenwood M. et al. Effect of budesonide/formoterol pressurized metered-dose inhaler on exacerbations versus formoterol in chronic obstructive pulmonary disease: The 6-month, randomized RISE (Revealing the Impact of Symbicort in reducing Exacerbations in COPD) study. Respir Med. 2017;132:31–41. https://doi.org/10.1016/j.rmed.2017.09.002.


Review

For citations:


Demko IV, Mamaeva MG, Sobko EA, Kraposhina AY, Gordeeva NV. Clinical experience of using formoterol/budesonide in patients with chronic obstructive pulmonary disease. Meditsinskiy sovet = Medical Council. 2021;(16):26-31. (In Russ.) https://doi.org/10.21518/2079-701X-2021-16-26-31

Views: 642


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)