Dual LABA/LAMA Therapy versus LABA or LAMA Monotherapy for Chronic Obstructive Pulmonary Disease. A Systematic Review and Meta-analysis in Support of the American Thoracic Society Clinical Practice Guideline.

Annals of the American Thoracic Society
Manoj J MammenPaul E Alexander

Abstract

Rationale: There is uncertainty on the optimal first-line therapy for symptomatic chronic obstructive pulmonary disease (COPD). Long-acting β2-receptor agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) have long been mainstays of treatment, though it is still not clear if dual therapy with LABA/LAMA is superior to monotherapy for symptomatic COPD.Objectives: To clarify the evidence landscape, we conducted a systematic review to answer the following question: in patients with COPD who complain of dyspnea and/or exercise intolerance, is LABA/LAMA combination therapy more effective and equally safe compared with LABA or LAMA monotherapy?Methods: A search of Medline, EMBASE, and the Cochrane Library databases was conducted by a medical librarian for randomized controlled trials enrolling patients with COPD who complain of dyspnea and/or exercise intolerance that compare LABA/LAMA combination therapy to LABA or LAMA monotherapy. A systematic approach was used to screen, abstract, and critically appraise the emerging study evidence. The Grading of Recommendations Assessment, Development, and Evaluation method was applied to rate the certainty and quality of the evidence.Results: A total of 24 studies were eligible for i...Continue Reading

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Citations

Mar 23, 2021·Respirology : Official Journal of the Asian Pacific Society of Respirology·Martin I MacDonald, Philip G Bardin
Apr 13, 2021·Archivos de bronconeumología·Marc MiravitllesJuan José Soler-Cataluña
Jul 9, 2021·International Journal of Chronic Obstructive Pulmonary Disease·Leif BjermerClaus F Vogelmeier
Jan 19, 2022·Journal of Internal Medicine·Pere AlmagroPablo Martínez-Camblor

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