Treatment efficacy of LAMA versus placebo for stable chronic obstructive pulmonary disease: A systematic review and meta-analysis
Four long-acting muscarinic antagonists (LAMAs), tiotropium, glycopyrronium, aclidinium, and umeclidinium, are currently available for the treatment of stable chronic obstructive pulmonary disease (COPD). However, no integrated analysis has sought to determine the effectiveness of these LAMAs. Thus,...
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| Veröffentlicht in: | Respiratory investigation 2022-01, Vol.60 (1), p.108-118 |
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| creator | Suzuki, Yasuhito Sato, Suguru Sato, Kento Inoue, Sumito Shibata, Yoko |
| description | Four long-acting muscarinic antagonists (LAMAs), tiotropium, glycopyrronium, aclidinium, and umeclidinium, are currently available for the treatment of stable chronic obstructive pulmonary disease (COPD). However, no integrated analysis has sought to determine the effectiveness of these LAMAs. Thus, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of LAMA versus placebo in patients with stable COPD.
A literature search of relevant randomized control trials that administered LAMA to stable COPD patients was conducted, and the exacerbations, quality of life (QoL), dyspnea score, lung function, and adverse event of patients were evaluated.
A total of 33 studies were included in this meta-analysis. LAMA significantly decreased the frequency of exacerbations compared to the placebo (OR 0.75; 95% CI 0.66 to 0.85; P |
| doi_str_mv | 10.1016/j.resinv.2021.08.002 |
| format | Article |
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A literature search of relevant randomized control trials that administered LAMA to stable COPD patients was conducted, and the exacerbations, quality of life (QoL), dyspnea score, lung function, and adverse event of patients were evaluated.
A total of 33 studies were included in this meta-analysis. LAMA significantly decreased the frequency of exacerbations compared to the placebo (OR 0.75; 95% CI 0.66 to 0.85; P < 0.001). The mean changes in the St George's Respiratory Questionnaire score (mean difference, −3.61; 95% CI, −4.27 to −2.95; P < 0.00001), transitional dyspnea index score (mean difference 1.00; 95% CI 0.83 to 1.17; P < 0.00001), and trough FEV1 (mean difference 0.12; 95% CI 0.11 to 0.13; P < 0.0001) indicated significantly greater improvement in the LAMA group than the placebo group. The number of withdrawals due to adverse events in the LAMA group was significantly fewer than that in the placebo group (OR -0.02; 95% CI -0.03 to −0.01; P = 0.002).
LAMA is superior to placebo due to lower frequency of exacerbations and adverse events, as well as higher trough FEV1, QoL, and dyspnea score for stable COPD.</description><identifier>ISSN: 2212-5345</identifier><identifier>EISSN: 2212-5353</identifier><identifier>DOI: 10.1016/j.resinv.2021.08.002</identifier><identifier>PMID: 34489206</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adrenergic beta-2 Receptor Agonists - therapeutic use ; Bronchodilator Agents - therapeutic use ; Chronic obstructive pulmonary disease ; Humans ; Long-acting muscarinic antagonist ; Meta-analysis ; Muscarinic Antagonists - therapeutic use ; Pulmonary Disease, Chronic Obstructive - drug therapy ; Quality of Life ; Randomized Controlled Trials as Topic ; Systematic review ; Tiotropium Bromide - therapeutic use ; Treatment Outcome</subject><ispartof>Respiratory investigation, 2022-01, Vol.60 (1), p.108-118</ispartof><rights>2021 The Japanese Respiratory Society</rights><rights>Copyright © 2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-5ddc14f53294c97427aff7c87c0e6089f19e49e83933d3d700a61613ec5353873</citedby><cites>FETCH-LOGICAL-c428t-5ddc14f53294c97427aff7c87c0e6089f19e49e83933d3d700a61613ec5353873</cites><orcidid>0000-0002-1817-9761 ; 0000-0001-9675-9051 ; 0000-0003-1794-0026</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34489206$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suzuki, Yasuhito</creatorcontrib><creatorcontrib>Sato, Suguru</creatorcontrib><creatorcontrib>Sato, Kento</creatorcontrib><creatorcontrib>Inoue, Sumito</creatorcontrib><creatorcontrib>Shibata, Yoko</creatorcontrib><title>Treatment efficacy of LAMA versus placebo for stable chronic obstructive pulmonary disease: A systematic review and meta-analysis</title><title>Respiratory investigation</title><addtitle>Respir Investig</addtitle><description>Four long-acting muscarinic antagonists (LAMAs), tiotropium, glycopyrronium, aclidinium, and umeclidinium, are currently available for the treatment of stable chronic obstructive pulmonary disease (COPD). However, no integrated analysis has sought to determine the effectiveness of these LAMAs. Thus, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of LAMA versus placebo in patients with stable COPD.
A literature search of relevant randomized control trials that administered LAMA to stable COPD patients was conducted, and the exacerbations, quality of life (QoL), dyspnea score, lung function, and adverse event of patients were evaluated.
A total of 33 studies were included in this meta-analysis. LAMA significantly decreased the frequency of exacerbations compared to the placebo (OR 0.75; 95% CI 0.66 to 0.85; P < 0.001). The mean changes in the St George's Respiratory Questionnaire score (mean difference, −3.61; 95% CI, −4.27 to −2.95; P < 0.00001), transitional dyspnea index score (mean difference 1.00; 95% CI 0.83 to 1.17; P < 0.00001), and trough FEV1 (mean difference 0.12; 95% CI 0.11 to 0.13; P < 0.0001) indicated significantly greater improvement in the LAMA group than the placebo group. The number of withdrawals due to adverse events in the LAMA group was significantly fewer than that in the placebo group (OR -0.02; 95% CI -0.03 to −0.01; P = 0.002).
LAMA is superior to placebo due to lower frequency of exacerbations and adverse events, as well as higher trough FEV1, QoL, and dyspnea score for stable COPD.</description><subject>Adrenergic beta-2 Receptor Agonists - therapeutic use</subject><subject>Bronchodilator Agents - therapeutic use</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Humans</subject><subject>Long-acting muscarinic antagonist</subject><subject>Meta-analysis</subject><subject>Muscarinic Antagonists - therapeutic use</subject><subject>Pulmonary Disease, Chronic Obstructive - drug therapy</subject><subject>Quality of Life</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Systematic review</subject><subject>Tiotropium Bromide - therapeutic use</subject><subject>Treatment Outcome</subject><issn>2212-5345</issn><issn>2212-5353</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1rHDEQhkVwiI3jfxCCSje71td-uTAcxvmAC2mcWuikEdGxuzprtGeuzD-3jnNcepqZ4pkZ3oeQL5zVnPH2ZlsnwDDva8EEr1lfMyY-kAshuKga2cizt1k15-QKcctKtY1QvP1EzqVS_SBYe0H-PSYweYI5U_A-WGMPNHq6Xv1a0T0kXJDuRmNhE6mPiWI2mxGo_ZviHCyNG8xpsTnsge6WcYqzSQfqAoJBuKUrigfMMJlc2AT7AM_UzI5OkE1lZjMeMOBn8tGbEeHqtV-SP98eHu9_VOvf33_er9aVVaLPVeOc5co3UgzKDp0SnfG-s31nGbSsHzwfQA3Qy0FKJ13HmGl5yyXYo4--k5fk-nR3l-LTApj1FNDCOJoZ4oJaNB3jnDVcFVSdUJsiYgKvdylMJZrmTB_9660--ddH_5r1uvgva19fPyybCdzb0n_bBbg7AVByFhtJow0wW3Ahgc3axfD-hxfuPJmR</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Suzuki, Yasuhito</creator><creator>Sato, Suguru</creator><creator>Sato, Kento</creator><creator>Inoue, Sumito</creator><creator>Shibata, Yoko</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1817-9761</orcidid><orcidid>https://orcid.org/0000-0001-9675-9051</orcidid><orcidid>https://orcid.org/0000-0003-1794-0026</orcidid></search><sort><creationdate>202201</creationdate><title>Treatment efficacy of LAMA versus placebo for stable chronic obstructive pulmonary disease: A systematic review and meta-analysis</title><author>Suzuki, Yasuhito ; Sato, Suguru ; Sato, Kento ; Inoue, Sumito ; Shibata, Yoko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-5ddc14f53294c97427aff7c87c0e6089f19e49e83933d3d700a61613ec5353873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adrenergic beta-2 Receptor Agonists - therapeutic use</topic><topic>Bronchodilator Agents - therapeutic use</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Humans</topic><topic>Long-acting muscarinic antagonist</topic><topic>Meta-analysis</topic><topic>Muscarinic Antagonists - therapeutic use</topic><topic>Pulmonary Disease, Chronic Obstructive - drug therapy</topic><topic>Quality of Life</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Systematic review</topic><topic>Tiotropium Bromide - therapeutic use</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suzuki, Yasuhito</creatorcontrib><creatorcontrib>Sato, Suguru</creatorcontrib><creatorcontrib>Sato, Kento</creatorcontrib><creatorcontrib>Inoue, Sumito</creatorcontrib><creatorcontrib>Shibata, Yoko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suzuki, Yasuhito</au><au>Sato, Suguru</au><au>Sato, Kento</au><au>Inoue, Sumito</au><au>Shibata, Yoko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment efficacy of LAMA versus placebo for stable chronic obstructive pulmonary disease: A systematic review and meta-analysis</atitle><jtitle>Respiratory investigation</jtitle><addtitle>Respir Investig</addtitle><date>2022-01</date><risdate>2022</risdate><volume>60</volume><issue>1</issue><spage>108</spage><epage>118</epage><pages>108-118</pages><issn>2212-5345</issn><eissn>2212-5353</eissn><abstract>Four long-acting muscarinic antagonists (LAMAs), tiotropium, glycopyrronium, aclidinium, and umeclidinium, are currently available for the treatment of stable chronic obstructive pulmonary disease (COPD). However, no integrated analysis has sought to determine the effectiveness of these LAMAs. Thus, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of LAMA versus placebo in patients with stable COPD.
A literature search of relevant randomized control trials that administered LAMA to stable COPD patients was conducted, and the exacerbations, quality of life (QoL), dyspnea score, lung function, and adverse event of patients were evaluated.
A total of 33 studies were included in this meta-analysis. LAMA significantly decreased the frequency of exacerbations compared to the placebo (OR 0.75; 95% CI 0.66 to 0.85; P < 0.001). The mean changes in the St George's Respiratory Questionnaire score (mean difference, −3.61; 95% CI, −4.27 to −2.95; P < 0.00001), transitional dyspnea index score (mean difference 1.00; 95% CI 0.83 to 1.17; P < 0.00001), and trough FEV1 (mean difference 0.12; 95% CI 0.11 to 0.13; P < 0.0001) indicated significantly greater improvement in the LAMA group than the placebo group. The number of withdrawals due to adverse events in the LAMA group was significantly fewer than that in the placebo group (OR -0.02; 95% CI -0.03 to −0.01; P = 0.002).
LAMA is superior to placebo due to lower frequency of exacerbations and adverse events, as well as higher trough FEV1, QoL, and dyspnea score for stable COPD.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>34489206</pmid><doi>10.1016/j.resinv.2021.08.002</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-1817-9761</orcidid><orcidid>https://orcid.org/0000-0001-9675-9051</orcidid><orcidid>https://orcid.org/0000-0003-1794-0026</orcidid></addata></record> |
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| subjects | Adrenergic beta-2 Receptor Agonists - therapeutic use Bronchodilator Agents - therapeutic use Chronic obstructive pulmonary disease Humans Long-acting muscarinic antagonist Meta-analysis Muscarinic Antagonists - therapeutic use Pulmonary Disease, Chronic Obstructive - drug therapy Quality of Life Randomized Controlled Trials as Topic Systematic review Tiotropium Bromide - therapeutic use Treatment Outcome |
| title | Treatment efficacy of LAMA versus placebo for stable chronic obstructive pulmonary disease: A systematic review and meta-analysis |
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