The effects of single inhaler triple therapy vs single inhaler dual therapy or separate triple therapy for the management of chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials

International Journal of Chronic Obstructive Pulmonary Disease
Chih-Cheng LaiYa-Hui Wang

Abstract

This study aims to compare the effects of single inhaler triple therapy comprised of inhaled corticosteroids (ICSs), long-acting β2-agonists (LABAs), and long-acting muscarinic receptor antagonists (LAMAs) with dual therapies comprised of either LABA/LAMA, ICS/LABA or separate ICS/LABA plus LAMA triple therapy. The Pubmed, Embase, and Cochrane databases were searched up to October 31st 2018. Only randomized controlled trials were included in the meta-analysis. The primary outcome was the rate of moderate-to-severe chronic obstructive pulmonary disease (COPD) exacerbations. Seven studies fulfilling the inclusion criteria were included in the meta-analysis. Single inhaler triple therapy was associated with a significantly lower risk of COPD exacerbation compared with LABA/LAMA (rate ratio, 0.69; 95% confidence interval [CI] 0.55 to 0.87, I2 =85%), and ICS/LABA (rate ratio, 0.81; 95% CI 0.73 to 0.89, I2 =29%) dual therapy. Single inhaler triple therapy led to a more significant improvement in lung function and quality of life compared with LABA/LAMA and ICS/LABA dual therapy. Single inhaler triple therapy was associated with a higher risk of pneumonia compared with LABA/LAMA (risk ratio, 1.38, 95% CI 1.14 to 1.67, I2 =0) dual ther...Continue Reading

Citations

Jul 1, 2020·Expert Review of Clinical Pharmacology·Luigino CalzettaMario Cazzola
Jul 21, 2020·Expert Opinion on Pharmacotherapy·Timothy E AlbertsonSusan Murin
Aug 9, 2020·International Journal of Chronic Obstructive Pulmonary Disease·Marc MiravitllesJaume Puig-Junoy
May 23, 2020·The European Respiratory Journal·Daiana Stolz, Marc Miravitlles
Jul 12, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Chih-Cheng Lai

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