Impact of ICS/LABA and LABA/LAMA FDCs on functional and clinical outcomes in COPD: A network meta-analysis.


Journal

Pulmonary pharmacology & therapeutics
ISSN: 1522-9629
Titre abrégé: Pulm Pharmacol Ther
Pays: England
ID NLM: 9715279

Informations de publication

Date de publication:
12 2019
Historique:
received: 03 07 2019
revised: 14 10 2019
accepted: 14 10 2019
pubmed: 23 10 2019
medline: 4 9 2020
entrez: 23 10 2019
Statut: ppublish

Résumé

Inhaled corticosteroid (ICS)/long-acting β A network meta-analysis (≥3 nodes, Bayesian method) was performed by searching for randomized clinical trials (RCTs) that compared the impact of different LABA/LAMA FDCs vs. ICS/LABA FDCs on both primary and secondary endpoints. The primary endpoints were: the change from baseline in trough forced expiratory volume in 1 s (FEV Data of 17,734 COPD patients were extracted from 16 RCTs. The length of treatment ranged from 6 weeks to 52 weeks. All LABA/LAMA FDCs, except aclidinium/formoterol, produced a statistically significant improvement compared to ICS/LABAs in trough FEV The results of this meta-analysis show that LABA/LAMA combinations are consistently more effective than ICS/LABA FDCs for most of the evaluated outcomes. However, differences have also been observed between FDCs belonging to the same class. Across the investigated LABA/LAMA FDCs, glycopyrronium/indacaterol revealed a consistent and robust efficacy profile.

Sections du résumé

BACKGROUND
Inhaled corticosteroid (ICS)/long-acting β
METHODS
A network meta-analysis (≥3 nodes, Bayesian method) was performed by searching for randomized clinical trials (RCTs) that compared the impact of different LABA/LAMA FDCs vs. ICS/LABA FDCs on both primary and secondary endpoints. The primary endpoints were: the change from baseline in trough forced expiratory volume in 1 s (FEV
RESULTS
Data of 17,734 COPD patients were extracted from 16 RCTs. The length of treatment ranged from 6 weeks to 52 weeks. All LABA/LAMA FDCs, except aclidinium/formoterol, produced a statistically significant improvement compared to ICS/LABAs in trough FEV
CONCLUSIONS
The results of this meta-analysis show that LABA/LAMA combinations are consistently more effective than ICS/LABA FDCs for most of the evaluated outcomes. However, differences have also been observed between FDCs belonging to the same class. Across the investigated LABA/LAMA FDCs, glycopyrronium/indacaterol revealed a consistent and robust efficacy profile.

Identifiants

pubmed: 31639476
pii: S1094-5539(19)30162-2
doi: 10.1016/j.pupt.2019.101855
pii:
doi:

Substances chimiques

Adrenergic beta-2 Receptor Agonists 0
Bronchodilator Agents 0
Drug Combinations 0
Glucocorticoids 0
Muscarinic Antagonists 0

Types de publication

Comparative Study Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

101855

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Luigino Calzetta (L)

Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.

Fabiano Di Marco (F)

Department of Health Sciences, University of Milan, Respiratory Unit ASST - Papa Giovanni XXIII Hospital, Bergamo, Italy. Electronic address: fabiano.dimarco@unimi.it.

Francesco Blasi (F)

Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Internal Medicine, Respiratory Unit and Adult Cystic Fibrosis Center, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Mario Cazzola (M)

Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.

Stefano Centanni (S)

Department of Health Sciences, University of Milan Respiratory Unit, ASST Santi Paolo e Carlo, Milan, Italy.

Claudio Micheletto (C)

Cardio-Thoracic Department, Respiratory Unit, Integrated University Hospital, Verona, Italy.

Andrea Rossi (A)

Respiratory Section, Department of Medicine, University of Verona, Italy.

Paola Rogliani (P)

Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.

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Classifications MeSH