Delaying disease progression in COPD with early escalation to triple therapy: a modelling study (DEPICT-2)
Introduction In patients with COPD, dual bronchodilator (long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA)) and triple therapy (inhaled corticosteroid/LAMA/LABA) reduce the risk of exacerbations and lung function decline in the short–mid-term, but their long-term impact is unkno...
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| Format: | Article |
| Language: | English |
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European Respiratory Society
2025-04-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/11/2/00438-2024.full |
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| author | Dave Singh Diego Fabian Litewka Joan B. Soriano Adrian Rendon Frederico Leon Arrabal Fernandes Rafael Páramo-Arroyo Tim Trinidad Hakan Günen Sudeep Acharya Bhumika Aggarwal Gur Levy Chris Compton Abdelkader El Hasnaoui Peter Daley-Yates |
| author_facet | Dave Singh Diego Fabian Litewka Joan B. Soriano Adrian Rendon Frederico Leon Arrabal Fernandes Rafael Páramo-Arroyo Tim Trinidad Hakan Günen Sudeep Acharya Bhumika Aggarwal Gur Levy Chris Compton Abdelkader El Hasnaoui Peter Daley-Yates |
| author_sort | Dave Singh |
| collection | DOAJ |
| description | Introduction
In patients with COPD, dual bronchodilator (long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA)) and triple therapy (inhaled corticosteroid/LAMA/LABA) reduce the risk of exacerbations and lung function decline in the short–mid-term, but their long-term impact is unknown. This modelling study explores long-term impact of these therapies on lung function decline, quality of life (QoL) and all-cause mortality.
Methods
This modelling approach used a longitudinal nonparametric superposition model using published data regarding exacerbations, QoL (assessed by St George's Respiratory Questionnaire (SGRQ)) and mortality. The model simulated disease progression from 40 to 75 years of age and assessed the impact of initiating dual bronchodilator at age 45 years (“LAMA/LABA only” group) and escalation to triple therapy at age 50 years (“Escalation to triple” group) on forced expiratory volume in 1 s (FEV1) decline, QoL and mortality.
Results
Model simulation predicted that by 75 years of age, “LAMA/LABA only” preserves 159.1 mL of FEV1 versus no treatment, while “Escalation to triple” preserves an additional 376.5 mL and 217.3 mL of FEV1 versus no pharmacotherapy and “LAMA/LABA only”, respectively. In “LAMA/LABA only”, the SGRQ score reduces (−3.2) versus no treatment, which further reduces to −7.5 in “Escalation to triple”. In “LAMA/LABA only”, mortality reduces by 5.4% by 75 years versus no treatment, while the “Escalation to triple” shows further decrease in mortality by 12.0%.
Conclusion
Early pharmacotherapy initiation and escalation from dual bronchodilator to triple therapy could slow disease progression by preserving lung function and improving QoL and survival in patients with COPD. |
| format | Article |
| id | doaj-art-35df4582f8db4266b541b255fd9c25ea |
| institution | Kabale University |
| issn | 2312-0541 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj-art-35df4582f8db4266b541b255fd9c25ea2025-08-20T03:52:32ZengEuropean Respiratory SocietyERJ Open Research2312-05412025-04-0111210.1183/23120541.00438-202400438-2024Delaying disease progression in COPD with early escalation to triple therapy: a modelling study (DEPICT-2)Dave Singh0Diego Fabian Litewka1Joan B. Soriano2Adrian Rendon3Frederico Leon Arrabal Fernandes4Rafael Páramo-Arroyo5Tim Trinidad6Hakan Günen7Sudeep Acharya8Bhumika Aggarwal9Gur Levy10Chris Compton11Abdelkader El Hasnaoui12Peter Daley-Yates13 Division of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK Unidad Neumonologia, Hospital Juan A. Fernandez, Buenos Aires, Argentina Servicio de Neumología, Hospital Universitario de la Princesa, Facultad de Medicina, Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain Universidad Autónoma de Nuevo Leon, Hospital Universitario “Dr Jose Eleuterio Gonzalez”, CIPTIR, Monterrey, Mexico Disciplina de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil Universidad Anáhuac Querétaro, Centro de Estudios Clinicos de Querétaro, Querétaro, Mexico University of Santo Tomas, Faculty of Medicine and Surgery, Manila, Philippines Health Sciences University, Süreyyapaşa Research and Training Center for Chest Diseases and Thoracic Surgery, Istanbul, Turkey Emerging Markets, GlaxoSmithKline, Singapore Emerging Markets, GlaxoSmithKline, Singapore Emerging Markets, GSK, Panama City, Panama GSK, Brentford, UK Emerging Markets, GSK, Dubai, United Arab Emirates Independent Clinical Pharmacology Consultant, London, UK Introduction In patients with COPD, dual bronchodilator (long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA)) and triple therapy (inhaled corticosteroid/LAMA/LABA) reduce the risk of exacerbations and lung function decline in the short–mid-term, but their long-term impact is unknown. This modelling study explores long-term impact of these therapies on lung function decline, quality of life (QoL) and all-cause mortality. Methods This modelling approach used a longitudinal nonparametric superposition model using published data regarding exacerbations, QoL (assessed by St George's Respiratory Questionnaire (SGRQ)) and mortality. The model simulated disease progression from 40 to 75 years of age and assessed the impact of initiating dual bronchodilator at age 45 years (“LAMA/LABA only” group) and escalation to triple therapy at age 50 years (“Escalation to triple” group) on forced expiratory volume in 1 s (FEV1) decline, QoL and mortality. Results Model simulation predicted that by 75 years of age, “LAMA/LABA only” preserves 159.1 mL of FEV1 versus no treatment, while “Escalation to triple” preserves an additional 376.5 mL and 217.3 mL of FEV1 versus no pharmacotherapy and “LAMA/LABA only”, respectively. In “LAMA/LABA only”, the SGRQ score reduces (−3.2) versus no treatment, which further reduces to −7.5 in “Escalation to triple”. In “LAMA/LABA only”, mortality reduces by 5.4% by 75 years versus no treatment, while the “Escalation to triple” shows further decrease in mortality by 12.0%. Conclusion Early pharmacotherapy initiation and escalation from dual bronchodilator to triple therapy could slow disease progression by preserving lung function and improving QoL and survival in patients with COPD.http://openres.ersjournals.com/content/11/2/00438-2024.full |
| spellingShingle | Dave Singh Diego Fabian Litewka Joan B. Soriano Adrian Rendon Frederico Leon Arrabal Fernandes Rafael Páramo-Arroyo Tim Trinidad Hakan Günen Sudeep Acharya Bhumika Aggarwal Gur Levy Chris Compton Abdelkader El Hasnaoui Peter Daley-Yates Delaying disease progression in COPD with early escalation to triple therapy: a modelling study (DEPICT-2) ERJ Open Research |
| title | Delaying disease progression in COPD with early escalation to triple therapy: a modelling study (DEPICT-2) |
| title_full | Delaying disease progression in COPD with early escalation to triple therapy: a modelling study (DEPICT-2) |
| title_fullStr | Delaying disease progression in COPD with early escalation to triple therapy: a modelling study (DEPICT-2) |
| title_full_unstemmed | Delaying disease progression in COPD with early escalation to triple therapy: a modelling study (DEPICT-2) |
| title_short | Delaying disease progression in COPD with early escalation to triple therapy: a modelling study (DEPICT-2) |
| title_sort | delaying disease progression in copd with early escalation to triple therapy a modelling study depict 2 |
| url | http://openres.ersjournals.com/content/11/2/00438-2024.full |
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