Systematic literature review and meta-analysis of US-approved LAMA/LABA therapies versus tiotropium in moderate-to-severe COPD.

NPJ Primary Care Respiratory Medicine
MeiLan K HanBeth Hahn

Abstract

Dual bronchodilator maintenance therapy may benefit patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) versus long-acting muscarinic antagonist (LAMA) monotherapy. The efficacy and safety of US-approved LAMA/long-acting beta-agonist (LABA) combinations versus tiotropium (TIO), a LAMA, were assessed. This systematic review and meta-analysis (GSK: 206938), conducted in MEDLINE, MEDLINE In-process, and EMBASE following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, identified randomized clinical trials (>8 weeks) in moderate-to-severe COPD (per Global Initiative for Chronic Obstructive Lung Disease guidelines), receiving LAMA/LABA or TIO. difference in change from baseline in lung function (forced expiratory volume in 1 s [FEV1]; trough, peak, area under the curve 0-3 h post-dose (AUC0-3), St George's Respiratory Questionnaire (SGRQ) responder rate (≥4-unit improvement), SGRQ total score, and rescue medication use at 12 and 24 weeks. Safety was also assessed. From 5683 citations, the meta-analysis included eight clinical trials. LAMA/LABA significantly improved FEV1 trough (Week 12: 63.0 mL, 95% confidence intervals [CI]: 39.2, 86.8; Week 24: 66.1 mL, 95% CI: 40.0, 92.3), ...Continue Reading

References

Jun 1, 1992·The American Review of Respiratory Disease·P W JonesP Littlejohns
May 29, 1998·American Journal of Respiratory and Critical Care Medicine·T A SeemungalJ A Wedzicha
Dec 2, 2006·COPD·Paul W Jones
Jan 16, 2014·International Journal of Chronic Obstructive Pulmonary Disease·Yogesh Suresh PunekarHana Müllerova
Jan 13, 2015·The European Respiratory Journal·Roland BuhlEric Bateman
Sep 1, 2015·Respiratory Medicine·Dave SinghLeif Bjermer
Mar 11, 2017·International Journal of Chronic Obstructive Pulmonary Disease·Edward M KerwinWilliam A Fahy
Apr 1, 2017·International Journal of Chronic Obstructive Pulmonary Disease·Gustavo J RodrigoKonstantinos Kostikas

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