Dans le cadre d’un usage raisonné de la médication, la trithérapie inhalée combinant un bêta-2-mimétique à longue durée d’action, un anticholinergique à longue durée d’action et un corticostéroïde a-t-elle une place dans le traitement de fond de la bronchopneumopathie chronique obstructive ?
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Squilbin_Pauline_14411600_2020-2021.pdf
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- Background and aims: These last years, new inhaled devices containing ICS, LABA and LAMA have been developed for the management of stable COPD. The benefits of triple therapy remain uncertain, as its target population. The aim of this master thesis is first to assess data for efficacity and security. It will then try to determine which subpopulation might benefits the more of these combined inhalers. Methods: A bibliographic search will be led in the recent clinical trials and meta-analyses assessing efficacity and security of triple therapy. Results: Triple therapy seems to improve symptoms, reduction of exacerbations and mortality but these results need to be seen with caution because they assess efficacity on a selected population who doesn’t represent real world COPD patients, but who tend to present features of asthma such as eosinophil inflammation or bronchodilator reversibility. Blood eosinophils count is the most studied predictor of triple therapy efficacity. Conclusion: Triple therapy containing a LABA, a LAMA and an ICS is beneficial for a precise COPD population, but more studies are needed to confirm the features of these patients.