%0 Journal Article
%T Systematic literature review and meta-analysis of US-approved LAMA/LABA therapies versus tiotropium in moderate-to-severe COPD
%J -
%D 2018
%R https://doi.org/10.1038/s41533-018-0099-1
%X 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. Endpoints: difference in change from baseline in lung function (forced expiratory volume in 1£¿s [FEV1]; trough, peak, area under the curve 0¨C3£¿h post-dose (AUC0¨C3), St George¡¯s Respiratory Questionnaire (SGRQ) responder rate (¡Ý4-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), peak (Week 12: 91.5£¿mL, 95% CI: 70.5, 112.4; Week 24: 92.4£¿mL, 95% CI: 72.9, 111.9), AUC0¨C3 (Week 12: 126.8£¿mL, 95% CI: 108.1, 145.4), SGRQ responder rate at Week 12 (risk ratio: 1.19; 95% CI: 1.09, 1.28), mean SGRQ total score (Week 12: £¿1.87, 95% CI: £¿2.72, £¿1.02; Week 24: £¿1.05, 95% CI: £¿2.02, £¿0.09), and rescue medication use (Week 24: £¿0.47 puffs/day, 95% CI: £¿0.64, £¿0.30) versus TIO (all p£¿¡Ü£¿0.03). The SGRQ responder rate at 24 weeks and adverse events were not significantly different between treatments. US-approved LAMA/LABA therapies improved lung function, SGR,Q and rescue medication use versus TIO, without compromising safety
%U https://www.nature.com/articles/s41533-018-0099-1