![]() ![]() Maintenance treatment for asthma not adequately controlled with a maintenance combination of ICS + LABAĪ Product labelling and product information displayed as the delivered doseī Product labelling and product information displayed as the metered doseĬ must have experienced at least one severe exacerbation, which has required the documented use of systemic corticosteroids in the previous 12 months while receiving optimised asthma therapy, despite documented formal assessment of and adherence to a correct inhaler technique Maintenance treatment for asthma not adequately controlled with a maintenance combination of ICS + LABA for patients who experienced one or more asthma exacerbations in the previous year Table 1: Triple therapy FDC inhalers 7-11 Severe asthma is defined by symptoms and/or exacerbations remaining uncontrolled despite addressing all potential contributing factors. inappropriate or incorrect use of medicines.1 Difficult-to-treat asthma is defined as asthma that remains uncontrolled despite high-dose ICS (more than 800 micrograms budesonide per day or equivalent) + LABA. Severe asthma is a subgroup of difficult-to-treat asthma. serious flare-ups (eg, hospital admission, intensive care unit admission, or mechanical ventilation in the previous year).frequent severe flare-ups (eg, more than one flare-up requiring treatment with oral corticosteroids in the previous year).requires the above treatments to prevent it from becoming uncontrolled.Īsthma is uncontrolled if any of the following are identified: 1.remains uncontrolled despite high-dose ICS + LABA (with a correct inhaler technique and good adherence) or maintenance oral corticosteroids, or.Severe asthma is defined as asthma that: 1 Triple therapy FDC inhalers may improve adherence by reducing the number of inhaler devices required for maintenance treatment, with fewer instructions and similar dosing regimens. In asthma, there is evidence of significant noncompliance and non-adherence to medicines.It updated the clinical criteria for indacaterol with glycopyrronium and mometasone (Enerzair Breezhaler), and amended the listing to Authority Required (Streamlined). The clinical criteria for tiotropium was also updated, but its restriction type remains unchanged. (Enerzair Breezhaler) and tiotropium (Spiriva Respimat). Prescribers should be aware of flow-on changes to the PBS listings of indacaterol with glycopyrronium and mometasone.It is the second triple therapy FDC inhaler to be listed on the PBS for this indication. On 1 April 2022, fluticasone with umeclidinium and vilanterol (Trelegy Ellipta) was listed on the PBS for severe asthma.Previously, only tiotropium was available as an add-on treatment. Treatment options for severe asthma on the PBS that don’t require specialist referral have expanded over the past year with the listings of triple therapy FDC (fixed-dosed combination) inhalers. ![]() Triple ICS/LABA/LAMA FDC and dual LABA/LAMA or ICS/LABA FDCs are characterized by specific efficacy/safety profiles in agreement with the level of blood eosinophil count at baseline.ĬOPD ICS LABA LAMA dual bronchodilation network meta-analysis triple therapy. The weighted efficacy/safety profile resulting from SUCRA provided the following ranking in patients with low eosinophil count: ICS/LABA/LAMA>LABA/LAMA≫ICS/LABA whereas in patients with high eosinophil count the ranking was as follows: ICS/LABA/LAMA>LABA/LAMA>ICS/LABA FDC. The treatment ranking was reported via the surface under the cumulative ranking curve analysis (SUCRA).ĭata obtained from 21,909 COPD patients were extracted from the ETHOS, KRONOS, IMPACT, and TRILOGY studies, the only that fulfilled the strict inclusion criteria of this research. either dual LABA/LAMA or ICS/LABA therapies administered at fixed-dose combination (FDC) via the same inhaler device.Ī network meta-analysis was performed to assess the efficacy/safety impact of triple ICS/LABA/LAMA FDC compared with dual LABA/LAMA and ICS/LBA FDCs administered via the same inhaler device in COPD patients. The aim of this study was a quantitative synthesis by considering the studies that directly compared triple ICS/LABA/LAMA vs. In some studies comparing triple with dual combination therapies in COPD there might be a possible effect of inhaler bias resulting from different inhaler devices being used in comparator arms. ![]()
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