Antonio Anzueto, MD, on Fluticasone Furoate/Umeclidinium/Vilanterol Compared With Tiotropium for COPD

In this video, Antonio Anzueto, MD, talks about the main take-away messages from his team's study that compared fluticasone furoate/umeclidinium/vilanterol in a single inhaler with tiotropium among patients with symptomatic COPD, who are at risk of exacerbations.

Additional Resource:

• Anzueto A, Obeid D, Bansal S, et al. Single-inhaler triple therapy fluticasone furoate/umeclidinium/vilanterol compared with tiotropium monotherapy in COPD: a post-hoc analysis by airflow. Paper presented at: CHEST Annual Meeting 2020; October 18-21, 2020; Virtual. https://journal.chestnet.org/article/S0012-3692(20)33702-8/fulltext 

Antonio R. Anzueto, MD, is a professor of medicine in the Division of Pulmonary Diseases at the University of Texas, San Antonio, and the chief of the Pulmonary Section at the South Texas Veterans Health Care System.

TRANSCRIPT:

My name is Antonio Anzueto. I’m a professor of medicine at the University of Texas, San Antonio. I'm also the section chief for pulmonary at the South Texas Veterans Health Care System.

I think there are 2 very important points. One is that we have to make a diagnosis of COPD. It’s estimated that half of the patients who have COPD today haven’t been identified; they haven’t been diagnosed. My advice is don't look for COPD in an 80-year-old man, a 75-year-old man because he has already been diagnosed, or he already have complications with cardiovascular disease.

The new face of COPD today: the women in her mid 50s. A matter of fact, most of the newly diagnosed COPD patients are under the age of 60, and they are primarily female. So, the first message is we have to make a diagnosis, is look for the disease, ideally should be made the diagnostic with the spirometry. I know now in the context of the COVID pandemic, there are some limitations, how you can make a spirometry. But this is the best tool we have today.

The second point is that this is a treatable disease. Once you identify the disease, there are 3 main elements to treat the disease. (1) If they smoke, they must stop smoking. It’s something you have to work with your patients. I know they want to stop but can’t. This is the most horrible of each. (2) They should exercise on a regular basis. So that's one part of the treatment.

The second part of the treatment is pharmacotherapy. So, pharmacotherapy would be long-acting bronchodilators. The treatment is not short-acting nebulized bronchodilators 3 or 4 times a day.

The treatment is long-acting bronchodilators. Twenty years ago, tiotropium showed that and continues to demonstrate it can improve lung function. And now having new medications with a combination of long-acting bronchodilators, triple therapies with inhaled corticosteroids can further improve function, quality of life, and decrease rates of exacerbations.

I hope I have provided you with useful information to your practice. And, remember, make a diagnosis because if you can treat that condition, you can significant impact the patient's life. Thank you.