Triple versus LAMA/LABA combination therapy for Japanese patients with COPD: A systematic review and meta-analysis
| العنوان: | Triple versus LAMA/LABA combination therapy for Japanese patients with COPD: A systematic review and meta-analysis |
|---|---|
| المؤلفون: | Naoya Fujino, Tomohiro Ichikawa, Mitsuhiro Yamada, Akira Koarai, Tomotaka Kawayama, Hisatoshi Sugiura |
| المصدر: | Respiratory Investigation. 60:90-98 |
| بيانات النشر: | Elsevier BV, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, medicine.medical_specialty, Combination therapy, Muscarinic Antagonists, Muscarinic Agonists, Rate ratio, law.invention, Pulmonary Disease, Chronic Obstructive, Japan, Randomized controlled trial, Adrenal Cortex Hormones, law, Internal medicine, Administration, Inhalation, Humans, Medicine, Adverse effect, Adrenergic beta-2 Receptor Agonists, COPD, biology, business.industry, Incidence (epidemiology), Odds ratio, Lama, medicine.disease, biology.organism_classification, Bronchodilator Agents, Quality of Life, Drug Therapy, Combination, business |
| الوصف: | Background In symptomatic COPD patients with a history of exacerbations, additional treatment with inhaled corticosteroid (ICS) to long-acting muscarinic antagonist (LAMA) and long-acting beta-agonist (LABA) combination therapy is recommended based on the evidence of low incidence of exacerbations but with a caution for pneumonia. However, ethnic differences may affect the response to drugs. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of this treatment in the Japanese population (PROSPERO: CRD42020191978). Methods We searched relevant randomized control trials and analyzed the exacerbations, quality of life, lung function, and adverse events including pneumonia and mortality as the outcomes of interest. Results We identified a total of three RCTs (N = 632). Treatment with ICS/LAMA/LABA triple therapy significantly decreased the exacerbations (rate ratio, 0.56; 95% CI, 0.38 to 0.85) and improved the trough FEV1 (mean difference, 0.04; 95% CI, 0.01 to 0.07) compared to LAMA/LABA therapy. However, triple therapy showed a significantly higher incidence of pneumonia compared to LAMA/LABA (odds ratio, 3.38; 95% CI, 1.58 to 7.22). Concerning other adverse events including mortality, there were no significant difference between these therapies. Conclusions In the current meta-analysis of the Japanese population, we confirmed that triple therapy causes a higher incidence of pneumonia than LAMA/LABA treatment but is a more preferable treatment since it showed a lower incidence of exacerbations and higher trough FEV1 in patients with symptomatic moderate to severe COPD. However, since the sample sizes were not statistically large enough, further trials involving Japanese patients are needed. |
| تدمد: | 2212-5345 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::173223f51dde804c628104b472a9c0e1Test https://doi.org/10.1016/j.resinv.2021.04.007Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....173223f51dde804c628104b472a9c0e1 |
| قاعدة البيانات: | OpenAIRE |
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However, ethnic differences may affect the response to drugs. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of this treatment in the Japanese population (PROSPERO: CRD42020191978). Methods We searched relevant randomized control trials and analyzed the exacerbations, quality of life, lung function, and adverse events including pneumonia and mortality as the outcomes of interest. Results We identified a total of three RCTs (N = 632). Treatment with ICS/LAMA/LABA triple therapy significantly decreased the exacerbations (rate ratio, 0.56; 95% CI, 0.38 to 0.85) and improved the trough FEV1 (mean difference, 0.04; 95% CI, 0.01 to 0.07) compared to LAMA/LABA therapy. However, triple therapy showed a significantly higher incidence of pneumonia compared to LAMA/LABA (odds ratio, 3.38; 95% CI, 1.58 to 7.22). Concerning other adverse events including mortality, there were no significant difference between these therapies. Conclusions In the current meta-analysis of the Japanese population, we confirmed that triple therapy causes a higher incidence of pneumonia than LAMA/LABA treatment but is a more preferable treatment since it showed a lower incidence of exacerbations and higher trough FEV1 in patients with symptomatic moderate to severe COPD. 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