Optimal perioperative LAMA / LABA inhaled therapy for patients with lung cancer, COPD

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06 Aug 2021

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Perioperative combination therapy using a long-acting muscarinic antagonist and a long-acting beta-agonist may be an optimal treatment for lung cancer and COPD patients undergoing cancer for lung surgery, have reported the researchers.

“Because the prognosis of patients with lung cancer complicated by COPD would be poor, it is important to provide respiratory care for an extended period of time, not just during the perioperative period” Yoko Azuma, MARYLAND, Assistant Professor in the Division of Thoracic Surgery at Toho University School of Medicine, Tokyo, Japan, and colleagues wrote in BMC Pulmonary Medicine. “The aim of this study [was] to determine the effects of perioperative LAMA / LABA treatment on perioperative lung function, postoperative morbidity and mortality, and long-term prognosis for patients with COPD and lung cancer.

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Researchers performed a retrospective review of the medical records of 130 consecutive patients who were re-diagnosed with COPD and underwent lung cancer surgery from January 2005 to October 2019. All patients received perioperative rehabilitation prior to being classified into groups according to type of perioperative inhalation therapy and management. used: 64 patients received the AMLA / BALA combination, 23 patients received AMLA only and 43 received rehabilitation only.

The researchers reported that the FEV1 values1 and FEV11 predicted percentage were significantly improved in patients who received preoperative LAMA / LABA treatment prior to lung cancer surgery (P 1 expected percentage, 10.8% vs. 6.8%).

Patients who received LAMA / LABA had a lower frequency of postoperative complications compared to patients who received LAMA only (P = .007). Those who received LAMA / LABA had lower rates of complications (21.9% vs. 52.2%), pneumonia (10.9% vs. 26.1%), acute respiratory failure (1.6% vs. 8, 7%), prolonged air leakage (9.4% vs. 21.7%) and atrial fibrillation (6.3% vs. 8.7%).

Compared to patients who received AMLA only or rehabilitation only, of the 61 patients with moderate to severe airflow limitation, those who received LAMA / LABA treatment had significantly longer overall survival (P = .049 and P = 0.001) and disease-free (P = .026 and P

Researchers also observed an association between lower recurrence rates and perioperative LAMA / LABA treatment compared to LAMA alone (P = .006) and rehabilitation only (P = .008).

“Our data demonstrate that LAMA / LABA therapy not only improves short-term outcomes such as respiratory function and postoperative complications, but also long-term prognosis in patients with lung cancer and COPD,” wrote Azuma and his colleagues. “Perioperative LAMA / LABA Combination Therapy is the optimal bronchodilator for patients with COPD who require surgery for lung cancer. “


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