Comparison of clinical efficacy between ultra-LABAs and ultra-LAMAs in COPD: a systemic review with meta-analysis of randomized controlled trialsopen access
- Authors
- Cho, Eun Yeong; Kim, Se Yong; Kim, Min-Ji; Kim, Seonwoo; Park, Dong Ah; Yoo, Kwang Ha; Park, Yong Bum; Hwang, Yong Il; Rhee, Chin Kook; Jung, Ji Ye; Lee, Hyun; Park, Hye Yun
- Issue Date
- Dec-2018
- Publisher
- AME PUBL CO
- Keywords
- Chronic obstructive pulmonary disease (COPD); ultra-long acting beta(2)-agonist (LABA); ultra-long-acting muscarinic antagonist (LAMA); meta-analysis
- Citation
- JOURNAL OF THORACIC DISEASE, v.10, no.12, pp.6522 - 6530
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF THORACIC DISEASE
- Volume
- 10
- Number
- 12
- Start Page
- 6522
- End Page
- 6530
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/2652
- DOI
- 10.21037/jtd.2018.11.50
- ISSN
- 2072-1439
- Abstract
- Background: A single long-acting bronchodilator, ultra-long acting muscarinic antagonist (ultra-LAMA) or ultra-long acting β2-agonist (ultra-LABA) is preferred for the initial treatment of patients with chronic obstructive pulmonary disease (COPD); however, there are few head-to-head comparative studies between the two. Here, a meta-analysis of randomized controlled trials was performed to compare the clinical efficacy between ultra-LABA and ultra-LAMA in patients with moderate-to-severe COPD.
Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched (to March 1, 2017) to identify all published randomized controlled trials.
Results: Of the 12,906 articles found by searching the databases, we obtained data from 10,591 patients with COPD (LABA, n=5,058; LAMA, n=5,533) in seven published studies. Our results showed that COPD exacerbation were significantly lower in patients taking ultra-LAMA than those taking ultra-LABA (odds ratio =0.857, P=0.0008). However, no significant differences were observed between ultra-LAMA and ultra-LABA patients regarding improvement in trough forced expiratory volume in 1 s, the transitional dyspnea index, or St. George’s Respiratory Questionnaire score.
Conclusions: This study suggests that COPD exacerbation occurred less often in patients taking an ultra-LAMA than in those taking an ultra-LABA with similar efficacy of lung function and quality of life.
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