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4yr
Share your Opinion: LAMA inhalers for COPD

Maintenance bronchodilator treatments of chronic obstructive pulmonary disease (COPD) include oral inhaled long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABA). These agents attenuate COPD symptoms and decrease the severity/number of exacerbations. They also enhance quality of life and heighten exercise capacity.



Tiotropium is a LAMA and anticholinergic, with similar degrees of affinity to M1 to M5 subtypes of muscarinic receptors. At the level of the airways, this agent inhibits M3-receptors at the smooth muscle, thus resulting in bronchodilation. In in vitro and in vivo studies, prevention of methacholine-induced bronchoconstriction effects lasted greater than 24 hours and were dose-dependent, with bronchodilation being mostly site specific. In clinical trials, handheld LAMA inhalers exhibited peak efficacy within 3 hours after the first dose.



What has your clinical experience been with LAMA inhalers? What is patient satisfaction regarding treatment?



https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8788262/

https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021395s029lbl.pdf

https://pro.boehringer-ingelheim.com/us/products/spiriva/copd 

 


  • 4yr
    I dont manage the use of these as an ED physician but have found those on them in the community are managed quite well in terms of need for repeat ED visits
  • 4yr
    Lots of success with them provided the patients start using before late stage is extremely important that the patients know how to use the inhalers properly - there are multiple types out there. I or my nurse instruct them how to use these - and the patient self administers his/her first dose in the office in front of us. Patents need to know that this medication works differently and have matching, reasonable expectations - we discuss this in the office.
  • 4yr
    I use LAMAs on all my copd patients and they help improve their lung function and reduce their symptoms. Patients have to be instructed to use the inhaler properly, many do not fully exhale prior to taking a dose. Patients are overall very satisfied.
  • 4yr
    Good success with LAMA's, but is critical to share YOUTUBE videos with a patient or send them to respiratory therapist to help with how to use the device. Every single device has a different delivery method as we all know.
  • 4yr
    LAMA inhalers are helpful with mild COPD and as an asthma adjunctive therapy. They are less effective than LAMA/LABA inhalers which usually are my first choice. When there is a risk for exacerbations and deterioration, I prefer triples such as Breztri and Trelegy.
  • 4yr
    I’ve had great success with LAMA. It was a game changer with the once a day mist in Spiriva. No need for coordination. Now with the LABA/LAMA combination even better. My patients compliance improved markedly and enjoy using it.
  • 4yr
    I have had good results using a LAMA 1st line for my mild COPD patients but usually go to a LAMA/LABA combination 1st line for my moderate patients.
  • 4yr
    Use LAMA in all but mild COPD patients with great use of lower dose of steroids in severe cases, lowers frequency of exacerbations.Has additive effect to LABA/ inhaled steroids
  • 4yr
    I've been in practice long enough to remember when the first LAMA hit the market. It was a game changer for most of my COPD patients. Very rarely have I had patients who experienced intolerable side effects from this class of medications. The vast majority of patients who are on a LAMA as part of their regimen seem to be very pleased.
  • 4yr
    Generally good way to start mild patients, avoid issues with LABA precautions (without ICS) low risk of side effects overall. Good data for exacerbation reduction with certain molecules as well.
  • 4yr
    Can recall when the first LAMA was available, and it was a great new option to have. Multiple options have since become available in isolation or in combination form. Overall these are excellent additions to the armamentarium and are almost universally well tolerated without concerning side effects. However with evolving recommendations, and the selection bias of the types/severities of COPD patients that present to my practice, it seems that I only have a handful of patients who are solely on a LAMA for maintenance therapy.
  • 4yr
    LAMA inhalers have been well received by my patients. Either alone or in combination of LABA/ICS , LAMA has been able to control symptoms of COPD. I also like LAMA nebulizer Yupelri, which has decreased the need for 4 nebulizer treatments with SAMA, for patients who can not take the inhaler therapy.
    Overall I am satisfied with the performance of LAMA and my patients also express a good deal of satisfaction with this medicine
  • 4yr
    LAMA Spiriva has been on the market a long time and have had good success. Newer data and GOLD recommendations pretty clear that LABA LAMA combination is more beneficial that either single agent alone. I've gone to Stiolto at "go to" first maintenance inhaler in any new COPD treatment naive patient who has more than just minimal/mild COPD.
  • 4yr
    Have had good success with LAMA inhalers. They result in reduced COPD symptoms and decrease frequency of COPD exacerbations. Patients report improvement in COPD symptoms with LAMAs. Use of LAMA inhalers is also consistent with COPD GOLD recommendations.
  • 4yr
    Lots of success…patients are satisfied

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