The effectiveness of bronchodilator therapy: an equation with many variables
Ignatova G.L., Antonov V.N.

South Ural State Medical University, Chelyabinsk

The article discusses the problems of the appointment of double bronchodilator therapy in the treatment of chronic obstructive pulmonary disease (COPD). For the treatment of COPD, fixed combinations of long-acting anticholinergic drugs and long-acting β₂-agonists (LAAD / LABA) with a duration of 24 hours are approved: glycopyrronium bromide / indacaterol, tiotropium / olodaterol, muclucidinium / vilanterol. These combinations showed an advantage over their monocomponents and placebo in terms of influencing the forced expiratory volume in 1 second, dyspnoea and quality of life, and they also showed a high safety.
 Aim: to study the efficacy, safety and compliance to the preparation glycopyrronium bromide / indacaterol 50/110 mcg in actual clinical practice. 
 Patients and methods: the study included 49 male patients treated in City Clinic No. 4 and the City Pulmonary Center in Chelyabinsk in 2016-2017. The analysis of drug therapy in all patients was carried out. The main endpoints of observation were: 1) for the effectiveness assessment - the dynamics of the mMRC index, the forced expiratory volume for the 1st second (FEV₁), the    BODE prognostic index, the number of exacerbations; 2) for safety assessment - the number of adverse events (ECG changes: number of extrasystoles, QT interval elongation, changes in pacemaker); 3) for the assessment of compliance - testing on the Moriska-Green questionnaire. The dynamics of the changes in the parameters was evaluated within 6 months from the beginning of therapy. The prognostic evaluation BODE index has been calculated.
 Results and conclusions: The use of double bronchodilator therapy with the combined preparation glycopyrronium bromide / indacaterol 50/110 μg is effective for improving the clinico-functional parameters of the respiratory system and the prognosis of patients with COPD, and it is safe from the point of view of the effect on the cardiovascular system. The combined drug provides the necessary compliance to the management of patients with different COPD.

Key words: COPD, double bronchodilation, glycopyrronium bromide / indacaterol. 
 For citation: Ignatova G.L., Antonov V.N. The effectiveness of bronchodilator therapy: an equation with many variables // RMJ. 2017. № 18. P. 1268–1272.