Base de dados : MEDLINE
Pesquisa : D02.145.074.722.822.887 [Categoria DeCS]
Referências encontradas : 946 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 95 ir para página                         

  1 / 946 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
Texto completo
[PMID]:29253920
[Au] Autor:Smith S; Edwards CT
[Ad] Endereço:Division of Child Health, Obstetrics & Gynaecology, School of Medicine, The University of Nottingham, 1701 E Floor, East Block Queens Medical Centre, Nottingham, NG7 2UH, UK.
[Ti] Título:Long-acting inhaled bronchodilators for cystic fibrosis.
[So] Source:Cochrane Database Syst Rev;12:CD012102, 2017 Dec 19.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cystic fibrosis is a life-limiting inherited condition which affects one in 2500 newborns in the UK and 70,000 children and adults worldwide. The condition is multifaceted and affects many systems in the body. The respiratory system is particularly affected due to a build up of thickened secretions and a predisposition to infection. Inhaled bronchodilators are prescribed for 80% of people with cystic fibrosis in order to widen the airways and alleviate symptoms. Both short- and long-acting inhaled bronchodilators are used to improve respiratory symptoms. Short-acting inhaled bronchodilators take effect in minutes and typically last for four to eight hours (muscarinic antagonists). Long-acting inhaled bronchodilators also take effect within minutes but typically last for around 12 hours and sometimes longer. This review is one of two which are replacing a previously published review of both long- and short-acting inhaled bronchodilators. OBJECTIVES: This review aims to evaluate long-acting inhaled bronchodilators in children and adults with cystic fibrosis in terms of clinical outcomes and safety. If possible, we aimed to assess the optimal drug and dosage regimen. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.Date of last search: 10 October 2017.We also carried out a separate search of Embase and the reference lists of included trials. We searched clinical trials registries for any ongoing trials and made contact with pharmaceutical companies for any further trials.Date of Embase search: 11 October 2017. SELECTION CRITERIA: Randomised or quasi-randomised parallel trials comparing long-acting inhaled bronchodilators (beta-2 agonists and muscarinic antagonists) with placebo, no treatment or a different long-acting inhaled bronchodilator in adults and children with cystic fibrosis. DATA COLLECTION AND ANALYSIS: Both authors independently assessed trials for inclusion (based on title, abstract and full text). The authors independently assessed the included trials for quality and risk of bias and extracted data. Discrepancies were resolved by a third party. MAIN RESULTS: The searches identified 195 unique references, of which 155 were excluded on title and abstract. We assessed the full texts of the remaining references, excluded 16 trials (28 references) and included four trials (12 references) in the review with 1082 participants.One trial (n = 16) measuring the effect of beta-2 agonists reported an improvement in forced expiratory volume at one second (FEV ) after treatment (at one month), but the trial was small with an unclear risk of bias so we judged the evidence to be very low quality. The trial did not report on participant-reported outcomes, quality of life or adverse events.Three trials (n = 1066) looked at the effects of the muscarinic antagonist tiotropium at doses of 2.5 µg and 5.0 µg in both the short term (up to 28 days) and the longer term (up to three months). Only one of the trials reported the change in FEV (L) after 28 days treatment and showed no significant difference between groups; with 2.5 µg tiotropium, mean difference (MD) -0.02 (95% confidence interval (CI) -0.13 to 0.09), or 5.0 µg tiotropium, MD 0.00 (95% CI -0.10 to 0.10) (moderate-quality evidence). All three trials of muscarinic antagonists provided data on adverse events which were found to differ little from placebo at doses of 2.5 µg, risk ratio (RR) 1.01 (95% CI 0.92 to 1.11) or 5.0 µg, RR 0.98 (95% CI 0.90 to 1.06). Very little participant-reported outcome data or quality of life data were available for analysis. Two of the trials were at low risk of bias overall whilst the remaining trial was at an unclear risk overall. AUTHORS' CONCLUSIONS: Neither long-acting beta-2 agonists nor long-acting muscarinic antagonist bronchodilators demonstrate improvement in our primary outcome of FEV . No difference was observed between intervention and placebo in terms of quality of life or adverse events. The quality of evidence for the use of beta-2 agonists was very low. The use of a long-acting inhaled bronchodilator may help to reduce the burden of treatment for people with cystic fibrosis as it is taken less often than a short-acting inhaled bronchodilator, but future trials would benefit from looking at the effects on our primary outcomes (spirometric changes from baseline, quality of life and adverse effects) in the longer term.
[Mh] Termos MeSH primário: Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico
Broncodilatadores/uso terapêutico
Fibrose Cística/tratamento farmacológico
Antagonistas Muscarínicos/uso terapêutico
Brometo de Tiotrópio/uso terapêutico
[Mh] Termos MeSH secundário: Administração por Inalação
Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem
Broncodilatadores/administração & dosagem
Progressão da Doença
Volume Expiratório Forçado/efeitos dos fármacos
Seres Humanos
Antagonistas Muscarínicos/administração & dosagem
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Fatores de Tempo
Brometo de Tiotrópio/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Adrenergic beta-2 Receptor Agonists); 0 (Bronchodilator Agents); 0 (Muscarinic Antagonists); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012102.pub2


  2 / 946 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29215216
[Au] Autor:Garrison SR; Allan GM
[Ad] Endereço:University of Alberta, Edmonton, AB, Canada
[Ti] Título:Tiotropium in Early-Stage COPD.
[So] Source:N Engl J Med;377(23):2293, 2017 12 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Derivados da Escopolamina
Brometo de Tiotrópio
[Mh] Termos MeSH secundário: Broncodilatadores
Seres Humanos
Doença Pulmonar Obstrutiva Crônica
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Bronchodilator Agents); 0 (Scopolamine Derivatives); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1713253


  3 / 946 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29215215
[Au] Autor:Kerwin E
[Ad] Endereço:Clinical Research Institute, Medford, OR ekerwin@criresearch.com
[Ti] Título:Tiotropium in Early-Stage COPD.
[So] Source:N Engl J Med;377(23):2292-3, 2017 12 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Derivados da Escopolamina
Brometo de Tiotrópio
[Mh] Termos MeSH secundário: Broncodilatadores
Seres Humanos
Doença Pulmonar Obstrutiva Crônica
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Bronchodilator Agents); 0 (Scopolamine Derivatives); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1713253


  4 / 946 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29215214
[Au] Autor:Qian G; Ying F; Li G
[Ad] Endereço:Ningbo First Hospital, Ningbo, China
[Ti] Título:Tiotropium in Early-Stage COPD.
[So] Source:N Engl J Med;377(23):2292, 2017 12 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Derivados da Escopolamina
Brometo de Tiotrópio
[Mh] Termos MeSH secundário: Broncodilatadores
Seres Humanos
Doença Pulmonar Obstrutiva Crônica
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Bronchodilator Agents); 0 (Scopolamine Derivatives); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1713253


  5 / 946 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29211676
[Au] Autor:Ran P; Zhou Y; Guan WJ
[Ad] Endereço:Guangzhou Medical University, Guangzhou, China
[Ti] Título:Tiotropium in Early-Stage COPD.
[So] Source:N Engl J Med;377(23):2293-2294, 2017 12 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Derivados da Escopolamina
Brometo de Tiotrópio
[Mh] Termos MeSH secundário: Broncodilatadores
Seres Humanos
Doença Pulmonar Obstrutiva Crônica
Resultado do Tratamento
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Bronchodilator Agents); 0 (Scopolamine Derivatives); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1713253


  6 / 946 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28877027
[Au] Autor:Zhou Y; Zhong NS; Li X; Chen S; Zheng J; Zhao D; Yao W; Zhi R; Wei L; He B; Zhang X; Yang C; Li Y; Li F; Du J; Gui J; Hu B; Bai C; Huang P; Chen G; Xu Y; Wang C; Liang B; Li Y; Hu G; Tan H; Ye X; Ma X; Chen Y; Hu X; Tian J; Zhu X; Shi Z; Du X; Li M; Liu S; Yu R; Zhao J; Ma Q; Xie C; Li X; Chen T; Lin Y; Zeng L; Ye C; Ye W; Luo X; Zeng L; Yu S; Guan WJ
[Ad] Endereço:From the National Center for Respiratory Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, the First Affiliated Hospital (Y.Z., N.Z., Xiaochen Li, S.C., J. Zheng, D.Z., W.G., P.R.), the Third Affiliated Hospital (L.W., G.H.), and Liwan Hospital (F.L.
[Ti] Título:Tiotropium in Early-Stage Chronic Obstructive Pulmonary Disease.
[So] Source:N Engl J Med;377(10):923-935, 2017 09 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients with mild or moderate chronic obstructive pulmonary disease (COPD) rarely receive medications, because they have few symptoms. We hypothesized that long-term use of tiotropium would improve lung function and ameliorate the decline in lung function in patients with mild or moderate COPD. METHODS: In a multicenter, randomized, double-blind, placebo-controlled trial that was conducted in China, we randomly assigned 841 patients with COPD of Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 1 (mild) or 2 (moderate) severity to receive a once-daily inhaled dose (18 µg) of tiotropium (419 patients) or matching placebo (422) for 2 years. The primary end point was the between-group difference in the change from baseline to 24 months in the forced expiratory volume in 1 second (FEV ) before bronchodilator use. Secondary end points included the between-group difference in the change from baseline to 24 months in the FEV after bronchodilator use and the between-group difference in the annual decline in the FEV before and after bronchodilator use from day 30 to month 24. RESULTS: Of 841 patients who underwent randomization, 388 patients in the tiotropium group and 383 in the placebo group were included in the full analysis set. The FEV in patients who received tiotropium was higher than in those who received placebo throughout the trial (ranges of mean differences, 127 to 169 ml before bronchodilator use and 71 to 133 ml after bronchodilator use; P<0.001 for all comparisons). There was no significant amelioration of the mean (±SE) annual decline in the FEV before bronchodilator use: the decline was 38±6 ml per year in the tiotropium group and 53±6 ml per year in the placebo group (difference, 15 ml per year; 95% confidence interval [CI], -1 to 31; P=0.06). In contrast, the annual decline in the FEV after bronchodilator use was significantly less in the tiotropium group than in the placebo group (29±5 ml per year vs. 51±6 ml per year; difference, 22 ml per year [95% CI, 6 to 37]; P=0.006). The incidence of adverse events was generally similar in the two groups. CONCLUSIONS: Tiotropium resulted in a higher FEV than placebo at 24 months and ameliorated the annual decline in the FEV after bronchodilator use in patients with COPD of GOLD stage 1 or 2. (Funded by Boehringer Ingelheim and others; Tie-COPD ClinicalTrials.gov number, NCT01455129 .).
[Mh] Termos MeSH primário: Broncodilatadores/uso terapêutico
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
Brometo de Tiotrópio/uso terapêutico
[Mh] Termos MeSH secundário: Administração por Inalação
Idoso
Broncodilatadores/efeitos adversos
Progressão da Doença
Método Duplo-Cego
Feminino
Volume Expiratório Forçado/efeitos dos fármacos
Seres Humanos
Masculino
Meia-Idade
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Qualidade de Vida
Brometo de Tiotrópio/efeitos adversos
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE IV; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Bronchodilator Agents); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170907
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1700228


  7 / 946 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28596292
[Au] Autor:Kistemaker LEM; Oenema TA; Baarsma HA; Bos IST; Schmidt M; Facchinetti F; Civelli M; Villetti G; Gosens R
[Ad] Endereço:Department of Molecular Pharmacology, University of Groningen, The Netherlands; l.e.m.kistemaker@rug.nl.
[Ti] Título:The PDE4 inhibitor CHF-6001 and LAMAs inhibit bronchoconstriction-induced remodeling in lung slices.
[So] Source:Am J Physiol Lung Cell Mol Physiol;313(3):L507-L515, 2017 Sep 01.
[Is] ISSN:1522-1504
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Combination therapy of PDE4 inhibitors and anticholinergics induces bronchoprotection in COPD. Mechanical forces that arise during bronchoconstriction may contribute to airway remodeling. Therefore, we investigated the impact of PDE4 inhibitors and anticholinergics on bronchoconstriction-induced remodeling. Because of the different mechanism of action of PDE4 inhibitors and anticholinergics, we hypothesized functional interactions of these two drug classes. Guinea pig precision-cut lung slices were preincubated with the PDE4 inhibitors CHF-6001 or roflumilast and/or the anticholinergics tiotropium or glycopyorrolate, followed by stimulation with methacholine (10 µM) or TGF-ß (2 ng/ml) for 48 h. The inhibitory effects on airway smooth muscle remodeling, airway contraction, and TGF-ß release were investigated. Methacholine-induced protein expression of smooth muscle-myosin was fully inhibited by CHF-6001 (0.3-100 nM), whereas roflumilast (1 µM) had smaller effects. Tiotropium and glycopyrrolate fully inhibited methacholine-induced airway remodeling (0.1-30 nM). The combination of CHF-6001 and tiotropium or glycopyrrolate, in concentrations partially effective by themselves, fully inhibited methacholine-induced remodeling in combination. CHF-6001 did not affect airway closure and had limited effects on TGF-ß -induced remodeling, but rather, it inhibited methacholine-induced TGF-ß release. The PDE4 inhibitor CHF-6001, and to a lesser extent roflumilast, and the LAMAs tiotropium and glycopyrrolate inhibit bronchoconstriction-induced remodeling. The combination of CHF-6001 and anticholinergics was more effective than the individual compounds. This cooperativity might be explained by the distinct mechanisms of action inhibiting TGF-ß release and bronchoconstriction.
[Mh] Termos MeSH primário: Remodelação das Vias Aéreas/efeitos dos fármacos
Broncoconstrição/efeitos dos fármacos
Antagonistas Colinérgicos/farmacologia
Nucleotídeo Cíclico Fosfodiesterase do Tipo 4/metabolismo
Pulmão/efeitos dos fármacos
Pulmão/fisiopatologia
Inibidores da Fosfodiesterase 4/farmacologia
Sulfonamidas/farmacologia
para-Aminobenzoatos/farmacologia
[Mh] Termos MeSH secundário: Aminopiridinas
Animais
Benzamidas
Ciclopropanos
Interações Medicamentosas
Glicopirrolato/farmacologia
Cobaias
Masculino
Cloreto de Metacolina/farmacologia
Brometo de Tiotrópio/farmacologia
Fator de Crescimento Transformador beta/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (3,5-dichloro-4-(2-(3-(cyclopropylmethoxy)-4-(difluoromethoxy)phenyl)-2-(3-(cyclopropylmethoxy)-4-(methylsulfonamido)benzoyloxy)ethyl)pyridine 1-oxide); 0 (Aminopyridines); 0 (Benzamides); 0 (Cholinergic Antagonists); 0 (Cyclopropanes); 0 (Phosphodiesterase 4 Inhibitors); 0 (Sulfonamides); 0 (Transforming Growth Factor beta); 0 (para-Aminobenzoates); 0P6C6ZOP5U (Roflumilast); 0W5ETF9M2K (Methacholine Chloride); EC 3.1.4.17 (Cyclic Nucleotide Phosphodiesterases, Type 4); V92SO9WP2I (Glycopyrrolate); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170610
[St] Status:MEDLINE
[do] DOI:10.1152/ajplung.00069.2017


  8 / 946 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28441979
[Au] Autor:Liccardi G; Calzetta L; Salzillo A; Apicella G; Croce G; Rogliani P
[Ti] Título:Can a better patients' phenotyping predict the efficacy of tiotropium in symptomatic asthma?
[So] Source:Allergy Asthma Proc;38(3):19-20, 2017 05 01.
[Is] ISSN:1539-6304
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Asma
Brometo de Tiotrópio
[Mh] Termos MeSH secundário: Administração por Inalação
Broncodilatadores
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Bronchodilator Agents); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170905
[Lr] Data última revisão:
170905
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.2500/aap.2017.38.4045


  9 / 946 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28430820
[Au] Autor:Trotta F; Spila-Alegiani S; Da Cas R; Rajevic M; Conti V; Venegoni M; Rossi M; Traversa G
[Ad] Endereço:Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
[Ti] Título:Cardiovascular safety of tiotropium Respimat vs HandiHaler in the routine clinical practice: A population-based cohort study.
[So] Source:PLoS One;12(4):e0176276, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The cardiovascular safety of tiotropium Respimat formulation in the routine clinical practice is still an open issue. Our aim was to compare the risk of acute myocardial infarction and heart rhythm disorders in incident users of either tiotropium Respimat or HandiHaler. The study population comprises patients aged ≥45 years, resident in two Italian regions with a first prescription of tiotropium (HandiHaler or Respimat) between 01/07/2011-30/11/2013. The cohort was identified through the database of prescriptions reimbursed by the Italian National Health Service. Comorbidities and clinical outcomes were obtained from hospital records. The primary outcome was the first hospitalization for acute myocardial infarction and/or for heart rhythm disorders during the exposure period. Hazard ratios were estimated in the propensity score-matched groups through Cox regression. After matching, 31,334 patients with incident prescription of tiotropium were included. The two groups were balanced with regard to baseline characteristics. Similar incidence rates of the primary outcome between Respimat and HandiHaler users were identified (adjusted hazard ratio 1.02, 95% CI 0.82-1.28). No risk difference between Respimat and HandiHaler emerged when considering clinical events separately. This large cohort study showed a comparable acute cardiovascular safety profile of the two tiotropium formulations.
[Mh] Termos MeSH primário: Broncodilatadores/uso terapêutico
Brometo de Tiotrópio/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Broncodilatadores/administração & dosagem
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Meia-Idade
Brometo de Tiotrópio/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bronchodilator Agents); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0176276


  10 / 946 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28392684
[Au] Autor:Wilson MR; Patel JG; Coleman A; McDade CL; Stanford RH; Earnshaw SR
[Ad] Endereço:RTI Health Solutions, Research Triangle Park, NC, USA.
[Ti] Título:Cost-effectiveness analysis of umeclidinium/vilanterol for the management of patients with moderate to very severe COPD using an economic model.
[So] Source:Int J Chron Obstruct Pulmon Dis;12:997-1008, 2017.
[Is] ISSN:1178-2005
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Bronchodilators such as long-acting muscarinic antagonists (LAMAs) and long-acting ß -agonists (LABAs) are central to the pharmacological management of COPD. Dual bronchodilation with umeclidinium/vilanterol (UMEC/VI; 62.5/25 µg) is a novel LAMA/LABA combination approved for maintenance treatment for patients with COPD. OBJECTIVE: The objective of this study was to assess the cost-effectiveness of maintenance treatment with UMEC/VI compared with tiotropium (TIO) 18 µg, open dual LAMA + LABA treatment, or no long-acting bronchodilator treatment in patients with moderate to very severe COPD. METHODS: A Markov model was developed to estimate the costs and outcomes associated with UMEC/VI treatment in patients with moderate to very severe COPD (GSK study number: HO-13-13411). Clinical efficacy, costs, utilities, and mortality obtained from the published literature were used as the model inputs. Costs are presented in US dollars based on 2015 prices. The model outputs are total costs, drug costs, other medical costs, number of COPD exacerbations, and quality-adjusted life-years (QALYs). Costs and outcomes were discounted at a 3% annual rate. Incremental cost-effectiveness ratios were calculated. One-way and probabilistic sensitivity analyses were conducted to assess the effects of changing parameters on the uncertainty of the results. RESULTS: UMEC/VI treatment for moderate to very severe COPD was associated with lower lifetime medical costs ($82,344) compared with TIO ($88,822), open dual LAMA + LABA treatment ($114,442), and no long-acting bronchodilator ($86,751). Fewer exacerbations were predicted to occur with UMEC/VI treatment compared with no long-acting bronchodilator treatment. UMEC/VI provided an 0.11 and 0.25 increase in QALYs compared with TIO and no long-acting bronchodilator treatment, and as such, dominated these cost-effectiveness analyses. Sensitivity analyses confirmed that the results were robust. CONCLUSION: The results from this model suggest that UMEC/VI treatment would be dominant compared with TIO and no long-acting bronchodilator treatment, and less costly than open dual LAMA + LABA treatment in patients with moderate to very severe COPD.
[Mh] Termos MeSH primário: Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem
Agonistas de Receptores Adrenérgicos beta 2/economia
Álcoois Benzílicos/administração & dosagem
Álcoois Benzílicos/economia
Broncodilatadores/administração & dosagem
Broncodilatadores/economia
Clorobenzenos/administração & dosagem
Clorobenzenos/economia
Custos de Medicamentos
Modelos Econômicos
Antagonistas Muscarínicos/administração & dosagem
Antagonistas Muscarínicos/economia
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
Doença Pulmonar Obstrutiva Crônica/economia
Quinuclidinas/administração & dosagem
Quinuclidinas/economia
[Mh] Termos MeSH secundário: Administração por Inalação
Agonistas de Receptores Adrenérgicos beta 2/efeitos adversos
Álcoois Benzílicos/efeitos adversos
Broncodilatadores/efeitos adversos
Clorobenzenos/efeitos adversos
Análise Custo-Benefício
Combinação de Medicamentos
Seres Humanos
Cadeias de Markov
Antagonistas Muscarínicos/efeitos adversos
Doença Pulmonar Obstrutiva Crônica/diagnóstico
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Anos de Vida Ajustados por Qualidade de Vida
Quinuclidinas/efeitos adversos
Índice de Gravidade de Doença
Fatores de Tempo
Brometo de Tiotrópio/administração & dosagem
Brometo de Tiotrópio/economia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenergic beta-2 Receptor Agonists); 0 (Benzyl Alcohols); 0 (Bronchodilator Agents); 0 (Chlorobenzenes); 0 (Drug Combinations); 0 (GSK573719); 0 (Muscarinic Antagonists); 0 (Quinuclidines); 028LZY775B (vilanterol); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.2147/COPD.S124420



página 1 de 95 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde