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Comparative efficacy of inhaled corticosteroid and long-acting beta agonist combinations in preventing COPD exacerbations: a Bayesian network meta-analysis
| Content Provider | Semantic Scholar |
|---|---|
| Author | Oba, Yoshiyuki Lone, Nazir Ahmed |
| Copyright Year | 2014 |
| Abstract | BACKGROUND A combination therapy with inhaled corticosteroid (ICS) and a long-acting beta agonist (LABA) is recommended in severe chronic obstructive pulmonary disease (COPD) patients experiencing frequent exacerbations. Currently, there are five ICS/LABA combination products available on the market. The purpose of this study was to systematically review the efficacy of various ICS/LABA combinations with a network meta-analysis. METHODS Several databases and manufacturer's websites were searched for relevant clinical trials. Randomized control trials, at least 12 weeks duration, comparing an ICS/LABA combination with active control or placebo were included. Moderate and severe exacerbations were chosen as the outcome assessment criteria. The primary analyses were conducted with a Bayesian Markov chain Monte Carlo method. RESULTS Most of the ICS/LABA combinations reduced moderate-to-severe exacerbations as compared with placebo and LABA, but none of them reduced severe exacerbations. However, many studies excluded patients receiving long-term oxygen therapy. Moderate-dose ICS was as effective as high-dose ICS in reducing exacerbations when combined with LABA. CONCLUSION ICS/LABA combinations had a class effect with regard to the prevention of COPD exacerbations. Moderate-dose ICS/LABA combination therapy would be sufficient for COPD patients when indicated. The efficacy of ICS/LABA combination therapy appeared modest and had no impact in reducing severe exacerbations. Further studies are needed to evaluate the efficacy of ICS/LABA combination therapy in severely affected COPD patients requiring long-term oxygen therapy. |
| Starting Page | 469 |
| Ending Page | 479 |
| Page Count | 11 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://ftp.ncbi.nlm.nih.gov/pub/pmc/d3/9c/copd-9-469.PMC4026563.pdf |
| Alternate Webpage(s) | https://www.dovepress.com/getfile.php?fileID=20003 |
| PubMed reference number | 24872685 |
| Alternate Webpage(s) | https://doi.org/10.2147/COPD.S48492 |
| DOI | 10.2147/copd.s48492 |
| Journal | International journal of chronic obstructive pulmonary disease |
| Volume Number | 9 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | 11-beta-Hydroxysteroid Dehydrogenases Adrenal Cortex Hormones Chronic Obstructive Airway Disease Exclusion Inspiration function Kartagener Syndrome Lung Diseases, Obstructive Lung diseases Oxygen Therapy Care Patients |
| Content Type | Text |
| Resource Type | Article |
