Advances in Respiratory Medicine

For the second consecutive year, GSK organized the meeting TOP 10 ATS/ERSan event that brought together pulmonologists from all over Spain to discuss the latest scientific and clinical advances in the field of respiratory medicine.

The main messages presented this year at the international congresses of the American Thoracic Society (ATS, held in May) and the European Respiratory Society (ERS, held this September), the two most important international congresses in the field of respiratory diseasesare included in the TOP 10 ATS/ERS to promote the continuing education of Spanish pulmonologists.

These experts were able to meet and exchange ideas from nine locations scattered throughout the national territory and connected to each other by streaming: Alicante, Barcelona, ​​Bilbao, Madrid, Salamanca, Santiago de Compostela, Seville and Valencia.

dr Bernardino Alcazarspecialist in pulmonology at the Virgen de las Nieves University Hospital in Granada, who emphasized the importance of this meeting for medical professionals and their update in the diagnosis and treatment of respiratory diseases and the management of patients with diseases such as lung canceron bronchial asthma and on COPDamong other pathologies.

The meeting concluded with ‘TOP 1’, the paper that summarized the new evidence presented by GSK at this year’s ATS Congress, the study of triple therapy with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) compared with other therapies for the treatment of COPD : A network meta-analysis suggesting a favorable trend for Trelegy Ellipta compared with other triple therapies in reducing moderate/severe exacerbations and improving lung function in patients with COPD.

This network meta-analysis made an indirect comparison of different COPD treatments; however, the inherent limitations of this type of study should be taken into account, such as the clinical heterogeneity of participants in each evaluated clinical trial, some differences in design, inclusion/exclusion criteria and in the definition of some parameters or the absence of some comparisons that do not were possible due to the lack of a common comparison tool in the meta-analysis network.

Currently, 210 million people worldwide live with COPD. “It represents the third cause of death worldwide and is one of the most common chronic respiratory diseases, due to prolonged exposure to agents that are harmful to the respiratory system, especially tobacco,” says Dr. Alcazar.

“We must not forget that COPD is a preventable and treatable disease. There are more and more therapeutic options; but 75% of patients do not know they have the disease until it is already at a very advanced stage, and therefore do not receive appropriate treatment in time”

Well slow onset and progressive diseasewhich manifests itself by violent attacks of coughing and expectoration, as a result of increasing labored breathing.

According to the doctor, “with the reduction of tobacco consumption in Spain over the last decade, we have witnessed a reduction of about 3% per year in COPD mortality in men and 1% in women, but there is still a long way to go, as in prevention, as well as in the clinical field to try to improve the quality of life of those who suffer from this disease”.

Among existing therapeutic options, Trelegy Ellipta is the first triple therapy for COPD patients with a single daily inhalation and in a single device and is specifically designed for those patients who do not have good control of symptoms and exacerbations with dual therapies (ICS/LABA or LAMA/LABA ). “The therapy combines three drugs, two bronchodilators that help the patient breathe better, and a corticosteroid that reduces inflammation of the bronchi and prevents crisis episodes, also called exacerbations, characterized by worsening symptoms,” explains Dr. Alcazar.

The network meta-analysis performed during the study was used to compare the efficacy of Trelegy Ellipta with that of other dual and triple therapy for patients with COPD. The results show a favorable trend for GSK treatment to reduce moderate and/or severe exacerbations in this type of patient and improve their lung function.

“In general, network meta-analyses use a somewhat complex methodology in terms of the mathematics and statistics used, but they are very effective in comparing multiple existing treatments and allow to determine which is the most effective and/or safe,” says Dr. r Alcázar. In this case, the medical records of 25,000 patients from all over the world, most of whom were over 60 years of age, with impaired lung function and frequent exacerbations were compared. “75% of the patients had 2 exacerbations in the year before the study or a severe crisis with admission to the hospital,” adds the specialist.

Specifically, compared to other fixed single-inhaler triple therapies (SITT), this network meta-analysis suggested that Trelegy Ellipta had greater improvements in the increase in minimum FEV1 – forced expiratory volume on respiratory function tests – at 12 and 24 weeks. Similarly, the combined annual rate of moderate and severe exacerbations improved significantlyindicating a favorable trend for this treatment compared to other therapeutic alternatives.

“We must not forget that COPD is a preventable and treatable disease. There are more and more therapeutic options; however, 75% of patients do not know they have the disease until it is already very advanced and therefore do not receive the appropriate treatment in time. Anyone with persistent respiratory symptoms should undergo spirometry, the most effective and safest test for early detection of COPD,” concludes Dr. Alcazar.

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