Dual– Versus Mono–Bronchodilator Therapy in Moderate to Severe COPD: A Meta-analysis
| العنوان: | Dual– Versus Mono–Bronchodilator Therapy in Moderate to Severe COPD: A Meta-analysis |
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| المؤلفون: | Sheila M. Wilhelm, Pramodini B Kale-Pradhan, Melissa Lipari |
| المصدر: | Annals of Pharmacotherapy. 54:1232-1242 |
| بيانات النشر: | SAGE Publications, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Moderate to severe, medicine.medical_specialty, medicine.drug_class, Pulmonary disease, Muscarinic Antagonists, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Forced Expiratory Volume, Internal medicine, Bronchodilator, Administration, Inhalation, medicine, Humans, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Adrenergic beta-2 Receptor Agonists, COPD, business.industry, Middle Aged, medicine.disease, Bronchodilator Agents, Treatment Outcome, 030228 respiratory system, Meta-analysis, Drug Therapy, Combination, business |
| الوصف: | Background: Chronic obstructive pulmonary disease (COPD) guidelines recommend both long-acting and dual bronchodilator therapy. It is unclear if there are differences in efficacy and safety. Objective: This meta-analysis evaluates the efficacy of dual therapy with long-acting β-agonist (LABA) + long acting muscarinic antagonist (LAMA) compared with monotherapy with LAMA for COPD. Methods: We searched PubMed, CINAHL, and Web of Science databases from inception through March 2020 to identify English-language, prospective randomized controlled trials (RCTs) that compared dual therapy with monotherapy in adult patients with COPD. Risk of bias was assessed using the Jadad score. Overall analysis was performed using Review Manager 5.3. Treatment effect was determined with the random-effects model using the Mantel-Haenszel method and was reported as mean difference (MD) with 95% CI. Results: A total of 18 RCTs were included (n = 6086; median Jadad score 5/5) that compared LAMA + LABA with LAMA. There was a greater improvement in forced expiratory volume at 1 s (FEV1) with dual therapy compared with LAMA: MD = 0.08; 95% CI = [0.05, 0.11]. There was no difference in St George Respiratory Questionnaire (SGRQ) scores between groups: OR = −0.85; 95% CI = [−1.83, 0.13]. There were no differences in overall adverse events (OR = 1.00; 95% CI = 0.92, 1.09), serious adverse events (OR = 1.01; 95% CI = 0.86, 1.18), or cardiovascular events (OR = 0.88; 95% CI = 0.58, 1.34). Conclusion and Relevance: Dual therapy improves FEV1 and is as safe as LAMA. Dual therapy does not improve SGRQ scores more than LAMA. |
| تدمد: | 1542-6270 1060-0280 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::17ae2a10a6002c3f1c731297539f15f3 https://doi.org/10.1177/1060028020932134 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....17ae2a10a6002c3f1c731297539f15f3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15426270 10600280 |
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