Identificador para citar o enlazar este ítem: http://hdl.handle.net/20.500.13003/17135
A Delphi Consensus Document on the Use of Single-Inhaler Fixed-Dose Triple Therapies in COPD Patients
Identificadores
DOI: 10.2147/COPD.S258818
ISSN: 1178-2005
WOS ID: 000552274600001
Scopus EID: 2-s2.0-85089176334
PMID: 32884252
Embase PUI: L2004801229
Compartir
Estadísticas
Ver estadísticas de uso de este ítemMetadatos
Ver el registro Dublin Core del ítemFecha de publicación
2020Tipo de documento
research articleCitación
Lopez-Campos JL, Alcazar Navarrete B, Riesco Miranda JA, Cosio BG, De-Torres JP, Celli B, et al. A Delphi Consensus Document on the Use of Single-Inhaler Fixed-Dose Triple Therapies in COPD Patients. Int J Chronic Obstr Pulm Dis. 2020;15:1801-11.Resumen
Introduction: Despite the evidence provided by clinical trials, there are some uncertainties and controversies regarding the use of triple inhaled therapy. With the aim of evaluating clinical practice in specialized respiratory units, a Delphi consensus document was implemented on the use of single-inhaler fixed-dose triple therapies after 1 year of use in Spain. Methods: A scientific committee of COPD experts defined a thematic index, guided a systematic literature review and helped design the Delphi questionnaire. This was sent to the other 45 COPD experts between April and June 2019. Agreement/disagreement on 58 statements was tested in two rounds using a Likert scale. Replies were classified as a consensus when >= 80% of the panelists agreed; a majority when a degree of agreement of >= 66% was reached; and divergence if agreement was <66%. Results: After two rounds, 44.44% of the statements reached consensus, 14.81% reached majority and 40.74% were divergent. Panelists agreed that escalating from double bronchodilation should be phenotype-based and aim to prevent exacerbations but not for improving symptoms. The addition of an antimuscarinic to inhaled corticosteroids combinations achieves improvement in lung function, symptoms and exacerbation prevention. Main safety concerns included the increased risk of pneumonia as compared to bronchodilator therapies, with similar cardiovascular effects. There was no consensus agreement on patient type response based on blood eosinophil counts or obstruction severity. Conclusion: The low degree of consensus among panelists may reflect the complexity of severe COPD management. The information provided here may be useful to clinicians implementing personalized medicine for COPD patients.
Versión del editor
https://dx.doi.org/10.2147/COPD.S258818Palabras clave
chronic obstructive pulmonary diseaseLABA/LAMA
LABA/ICS
bronchodilator agents
inhaled corticosteroids
triple therapy
statements
Delphi consensus
Colecciones de Docusalut en las que aparece este ítem
Hospital Universitario Son Espases - HUSE > Comunicación científicaInstituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científica