scholarly journals Efficiency and safety of roflumilast combined with long-acting bronchodilators on moderate-to-severe stable chronic obstructive pulmonary disease patients: a meta-analysis

2016 ◽  
Vol 8 (9) ◽  
pp. 2638-2645 ◽  
Author(s):  
Peng Luo ◽  
Shuo Li ◽  
Yitai Chen ◽  
Yuwen Luo ◽  
Yun Li ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Long Acting

scholarly journals Risk of Cardiovascular Events Associated with Inhaled Corticosteroid Treatment in Patients with Chronic Obstructive Pulmonary Disease: A Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Xia Jing ◽  
Yufeng Li ◽  
Jianying Xu
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Combination Group ◽  
Chronic Obstructive ◽  
Control Groups ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Long Acting ◽  
And Control

Background. The cardiovascular (CV) safety of inhaled corticosteroids (ICSs) in chronic obstructive pulmonary disease (COPD) is controversial because different studies have suggested that ICSs either increase or reduce the risk of CV events in COPD patients. In this meta-analysis, we assess the CV safety of ICS therapy in COPD. Methods. A meta-analysis of randomized, double-blind, parallel-group, placebo-controlled trials of ICS treatment for COPD that include at least 4 weeks of follow-up was performed. A random-effects model was used to evaluate the effects of ICS treatment on CV events. CV events were documented in each trial, and the relative risk (RR) and 95% confidence intervals (CIs) for ICSs were estimated. Results. Thirty-one trials were included in this meta-analysis. The risk of CV events was not different between ICS-treated and control groups (RR: 0.99; 95% CI: 0.93 to 1.06; P=0.801). In a subgroup analysis, there were no significant differences in CV events between an ICS combined with long-acting β2 agonist (LABA) (ICS + LABA) group and an LABA-only group (RR: 1.00; 95% CI: 0.90 to 1.10; P=0.930), as well as between a combination group (ICS + LABA) and a long-acting muscarinic antagonist (LAMA) combined with LABA (LAMA + LABA) group (RR: 0.78; 95% CI: 0.39 to 1.55; P=0.473). In addition, there was no difference in the risk of CV events between ICS treatment and control groups (RR: 0.99; 95% CI: 0.90 to 1.09; P=0.872). Conclusions. These results demonstrate that ICSs do not increase the risk of CV events in COPD patients.

scholarly journals Single-inhaler Triple vs Single-inhaler Dual Therapy in Patients with Chronic Obstructive Pulmonary Disease: A Meta-analysis of Randomized Control Trials

2021 ◽  
Author(s):  
Huanyu Long ◽  
Hongxuan Xu ◽  
Jean-Paul Janssens ◽  
Yanfei Guo
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Triple Therapy ◽  
Pulmonary Disease ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Dual Therapy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
All Cause Mortality ◽  
Long Acting

Abstract BACKGROUND: A meta-analysis was performed to compare the efficacy and safety of single-inhaler triple therapy combining long-acting beta2-agonist (LABA), long-acting muscarinic antagonist (LAMA), and inhaled corticosteroids (ICS) versus single-inhaler dual therapy (ICS/LABA and LABA/LAMA) in patients with chronic obstructive pulmonary disease (COPD).METHODS: We used the following search terms in PubMed, MEDLINE (OvidSP), EMBASE and Cochrane Library databases to investigate the effect of single-inhaler triple therapy in COPD. The primary end points were the effect of single-inhaler triple therapy on all-cause mortality, risk of acute exacerbation of COPD (AECOPD), and some safety endpoints, compared with single-inhaler dual therapy. Cochrane Collaboration's tool was used to assess quality of each randomized trial and risk of bias. RESULTS: A total of 25,171 patients suffering from COPD were recruited for the 6 studies. This meta-analysis indicated that single-inhaler triple therapy resulted in a significantly lower rate of all-cause mortality than single-inhaler dual therapy (risk ratio, 0.83; 95% CI 0.71‐0.98). Single-inhaler triple therapy reduced the risk of exacerbation (rate ratio, 0.78; 95% CI 0.73‐0.83), prolonged time to first exacerbation (hazard ratio, 0.86; 95% CI 0.84-0.89), improved trough FEV1 (mean difference, 81.35 ml; 95% CI 45.6–117.06) and St George Respiratory Questionnaire (SGRQ) Score (mean difference, -1.48; 95% CI -1.75–-1.22) vs. single-inhaler dual therapy. Risk of pneumonia was however significantly higher with ICS/LAMA/LABA than with LABA/LAMA (risk ratio, 1.25; 95% CI 1.04‐1.50). CONCLUSIONS: This meta-analysis suggests that single-inhaler triple therapy is effective in reducing the risk of moderate or severe exacerbations and death of any causes in COPD patients, compared with single-inhaler dual therapy. However, risk of pneumonia is higher with ICS/LAMA/LABA combination than with dual therapy of LABA/LAMA.TRIAL REGISTRY: ClinicalTrials.gov; No.: CRD42020186726; URL: www.clinicaltrials.gov.

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