Impact of ICS/LABA and LABA/LAMA FDCs on functional and clinical outcomes in COPD: A network meta-analysis
Pulmonary Pharmacology & Therapeutics, ISSN: 1094-5539, Vol: 59, Page: 101855
2019
- 15Citations
- 41Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
Citation Benchmarking is provided by Scopus and SciVal and is different from the metrics context provided by PlumX Metrics.
Metrics Details
- Citations15
- Citation Indexes15
- 15
- Captures41
- Readers41
- 41
Article Description
Inhaled corticosteroid (ICS)/long-acting β 2 agonist (LABA) fixed-dose combinations (FDCs) and LABA/long-acting muscarinic antagonist (LAMA) FDCs are extensively used to treat chronic obstructive pulmonary disease (COPD). The aim of the present network meta-analysis was to assess the comparative efficacy of all the currently available dual therapies in patients with moderate-to-severe COPD. 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 1 ) and the risk of exacerbation of COPD (AECOPD). The secondary endpoints were: peak FEV 1, St’ George's Respiratory Questionnaire (SGRQ), Transition Dyspnea Index (TDI), and rescue medication use. 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 1. The surface under the cumulative ranking curve (SUCRA) analysis indicated that umeclidinium/vilanterol, glycopyrronium/indacaterol and glycopyrrolate/formoterol fumarate were the most effective FDCs in improving trough FEV 1. Across the FDCs analyzed for the risk of AECOPD, glycopyrronium/indacaterol significantly reduced the exacerbation risk compared to fluticasone propionate/salmeterol and resulted the most effective combination in the SUCRA analysis. Similar trend were also observed for the peak FEV 1. No significant differences were detected across the investigated FDCs regarding SGRQ, TDI, and use of rescue medication. 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.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S1094553919301622; http://dx.doi.org/10.1016/j.pupt.2019.101855; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85073714973&origin=inward; http://www.ncbi.nlm.nih.gov/pubmed/31639476; https://linkinghub.elsevier.com/retrieve/pii/S1094553919301622; https://dx.doi.org/10.1016/j.pupt.2019.101855
Elsevier BV
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