Which patients with COPD could benefit from Trelegy Ellipta?

Patients with COPD who are symptomatic and at risk of an exacerbation despite ICS/LABA maintenance therapy (which may be prescribed with a separate LAMA) may be suitable for Trelegy Ellipta.¹

How can Trelegy Ellipta help your patients with COPD who are symptomatic and at risk of an exacerbation?

Watch how Trelegy Ellipta compared against an ICS/LABA in terms of exacerbation reduction, lung function and health-related quality of life.

How to identify patients with COPD who are symptomatic and at risk of exacerbation despite ICS/LABA maintenance therapy

Patients with COPD who are symptomatic and at risk of exacerbation can be difficult to identify. How can you uncover more when they tell you they "feel fine"?

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The consequences for patients who are symptomatic and at risk of exacerbation despite ICS/LABA maintenance therapy

Even a single exacerbation can lead to poorer outcomes²⁻⁴. What can you do for these at-risk patients?

Patient profile COPD

Meet Sylvia, she has COPD

She is on treatment with an ICS/LABA, symptomatic and at risk of an exacerbation:

  • Has worsening of symptoms, or
  • Has experienced an exacerbation treated with antibiotics or oral corticosteroid, in the past 12 months

How is COPD impacting her life?

  • Starting to miss social events with friends
  • Struggles to keep her small garden tidy
  • Difficulty walking to the shops
  • Can’t keep up when playing with young grandchildren

It is important to reduce exacerbations. Even a single exacerbation can lead to poorer outcomes for patients with COPD²⁻⁴

~37% faster decline in lung function vs. no exacerbation*²
 

2x increased risk of myocardial infarction in 1–5 days after exacerbation**³

~50% risk of death within 5 years following a hospitalised exacerbation⁴

*Post hoc analysis of the 3-year Toward a Revolution in COPD Health (TORCH) study in patients with moderate or severe COPD (treatment arms: salmeterol 50 mcg, fluticasone propionate 500 mcg, salmeterol/fluticasone propionate 50/500 mcg or placebo, all twice daily). The primary endpoint of the study did not reach statistical significance. Data shown compares patients with >0-1 moderate /severe exacerbations per annum vs. 0 exacerbations per annum. Analysis includes patients on active treatment and placebo.

Seretide (fluticasone propionate/salmeterol xinafoate) is indicated for the symptomatic treatment of patients with COPD, with a FEV₁ <60% predicted normal (pre-bronchodilator) and a history of repeated exacerbations, who have significant symptoms despite regular bronchodilator therapy.⁵ Seretide prescribing information.

**There was a 2.27 fold (95%CI, 1.1-4.7; p=0.03) increased relative risk of MI 1 to 5 days after exacerbation (defined by prescription of both steroids and antibiotics). There were 20,101 exacerbations and 8 MI events in the 1-5 day post exacerbation period, so the odds of an MI were 1 in 2513 exacerbations. The Health Improvement Network (THIN) database study: 25,857 patients with COPD in 277 practices from THIN database, 25 February 2003 – 24 February 2005

 

  • Trelegy Ellipta safety profile

    Common adverse reactions: headache, nasopharyngitis, influenza, upper respiratory tract infection, pneumonia, back pain, rhinitis, cough, pharyngitis, arthralgia, sinusitis, oropharyngeal pain, bronchitis, constipation, candidiasis of mouth and throat and urinary tract infection¹

    Cardiovascular: cardiovascular effects, such as cardiac arrhythmias (e.g. atrial fibrillation and tachycardia), may be seen after the administration of muscarinic receptor antagonists and sympathomimetics, including umeclidinium and vilanterol, respectively. Therefore, Trelegy Ellipta should be used with caution in patients with unstable or life-threatening cardiovascular disease.¹

    Pneumonia: in common with other corticosteroid-containing medicines, there is an increased risk of pneumonia in patients with COPD treated with Trelegy Ellipta, including pneumonia requiring hospitalisation. There is no conclusive clinical evidence for intra-class differences in the magnitude of the pneumonia risk among inhaled corticosteroid products. Physicians should remain vigilant for the possible development of pneumonia in patients with COPD as the clinical features of such infections overlap with the symptoms of COPD exacerbations. Risk factors for pneumonia in patients with COPD include current smoking, older age, low body mass index and severe COPD. Independent assessments & a head-to-head study showed no conclusive evidence of different pneumonia rates between inhaled corticosteroids including fluticasone furoate, beclometasone and budesonide containing medicines¹

Footnotes

ICS, inhaled corticosteroid; LABA, long-acting ß₂-agonist; LAMA, long-acting muscarinic antagonist; MI, myocardial infarction; QoL, quality of life

Trelegy Ellipta OD is indicated for maintenance treatment in adult patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are not adequately treated by a combination of an ICS and a LABA, or a combination of a LAMA and a LABA¹

References

  1. Trelegy SmPC
  2. Celli B et al. Am J Respir Crit Care Med 2008; 178:332-338 (see table 5, p.336)
  3. Donaldson GC et al. Chest 2010; 137:1091-1097
  4. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD) 2020 pages 30 and 105.
  5. Seretide Accuhaler SmPC

Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/ or search for MHRA Yellowcard in the Google Play or Apple App Store. Adverse events should also be reported to GlaxoSmithKline on 0800 221 441

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Trademarks are the property of their respective owners
Trelegy Ellipta was developed in collaboration with

PM-GB-FVU-WCNT-200012 | July 2020