Saturday, 26 March 2011

Clinical trial: Preventing COPD exacerbations, drug comparison

SPIRIVA was SUPERIOR to SEREVENT in prevention of COPD attacks in moderate and severe COPD patients.

What is COPD?

COPD stand for chronic obstructive pulmonary disease. There are 2 diseases included in COPD, these are emphysema and chronic bronchitis. Emphysema is defined in pathologic terms and is defined as destruction of the air sacs of the lung responsible for oxygen transfer into blood. Chronic bronchitis on the other hand is a clinical diagnosis with it being defined as cough with productive sputum (phlegm) for 3 consecutive months in 2 consecutive years.

there are many treatments available for COPD and involved usually a combination of a longer acting controller and a short acting rescue drug.


If you have been diagnosed with COPD, print this out. checklist for COPD

In the New England Journal of Medicine (march 2011 issue). Vogelmeier and his group have compared 2 effective inhalers for prevention of COPD attacks.

Attacks of COPD are essentially spells of increased shortness of breath and cough with sputum and can be triggered by infections, allergies or irritants in the air. Both tiotropium inhaled (know as SPIRIVA in USA, Boehringer Inc) and Salmeterol (known as SEREVENT DISKUS in USA, GSK) are recommended as controller medications for moderate to severe asthma.

A few studies have been done in the past which showed no difference in outcomes between the two but these were shorter term studies 3-6 months. This study compared head-to-head if one was better than the other and followed patients over a year. The group gathered data from about 6000 participants who were selected based on specific selection criteria.

Comparison goals were time to first attack, number of attacks, deaths and time for attack to subside.

Here are the results:

1. probability that patient will discontinue the medication was LOWER with SPIRIVA

This means that patient stay longer on the medication and get helped more.

2. Time to first exacerbation was LOWER with SPIRIVA

patients with SPIRIVA had exacerbations on an average 42 days later than those on SERVENT. This means SPIRIVA tends to control the COPD better than SERVENT.

3. Annual rate of exacerbations was LOWER with SPIRIVA

There were 11% MORE exacerbations when patients were on SERVENT


DISCUSSION

SPIRIVA was SUPERIOR to SEREVENT in prevention of COPD attacks in moderate and severe COPD patients.

Both SPIRIVA and SERVENT act to expand the air ways and improve air flow. SPIRIVA acts but blocking the cholinergic nerves while SERVENT acts by stimulating the adrenegic nerves. This study compares the two and provides good evidence that tiotropium is better. Thought there may be a difference in the way the drug reaches the lung and would have affected the results but the bottom line is that tiotropium did better than salmeterol.

Talk to your doctor! see what works out for you!! and oh yes DONT SMOKE if you have COPD.


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5 comments:

  1. Chronic obstructive lung disease (COPD) is a progressive disease that makes it difficult to breathe. The main cause of COPD is cigarette smoking.

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  2. Thank you for sharing this informative post, which explains about the COPD and the ways to prevent it. stem cell for copd

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  3. I was diagnose of Chronic Obstructive Pulmonary Disease (COPD) 2 years ago, my family doctor told me there is no cure but it can only be controled. Ever since then i have been running heather scepter looking for a solution to my problem because i was going to lose my Job if i dont get better, until i ran into this online testimony of Mrs Stacey who have been cured of COPD by this herbal clinic in Johannesburg (Ejiro Herbal Clinic), i immediately contacted them via their email (ejiroherbalclinic@gmail.com), to God be thy glory i bought this COPD herbal remedy and was cured within 3 weeks of usage, at last this is a break through for all COPD patients contact this herbal clinic via their email ejiroherbalclinic@gmail.com or call +27617403481

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  4. I smoked for 20 years, October 2014 i was diagnosed of Emphysema my doctor told me there is no permanent cure for the disease, i was given bronchodilators to help me relax my bronchiolar muscles, I managed on with the disease till a friend told me about a herbal doctor from South Africa who sell herbal medicines to cure all kind of diseases including emphysema, I contacted this herbal doctor via his email and made purchase of the emphysema herbal medicine, i received the herbal medicine through DHL within 5 days, when i received the herbal medicine i applied it as prescribed and was totally cured of emphysema within 18-20 days of usage, the symptoms reduced till i even forgot i had emphysema, i went back to my doctor for diagnosis with spirometry and he confirmed i was free from the disease, contact this herbal doctor via his email drlusandaherbal@gmail.com or website on www.drlusandaherbals.weebly.com

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  5. 2015 my mother was diagnosed of COPD/Emphysema ,i spent a lot of money on her medication till a point i even lost hope,because my mother was gradually dying and lost her memory too, i was so desperate to get my mother back to normal ,so one day my uncle who lives in United Kingdom told me about Dr Lusanda,who helped him get rid of Emphysema with herbal medicine ,i was so shocked when he told me that,but know is true because my uncle cant lie me ,so i contacted Dr Lusanda via his email;drlusandaherbal@drlusandaherbal.com, he replied and ask me to send my home address and my mother's detail and then i purchased the herbal medicine,sent me the herbal medicine through courier service, when i received this herbal medicine used it for 4 weeks, and after 4 weeks of usage my mother was totally cured of COPD/Emphysema,now my mother is living free and happy again ..all thanks to doctor Lusanda ..

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