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Long-acting beta2-agonists versus long-acting muscarinic antagonists in patients with stable COPD: A systematic review and meta-analysis of randomized controlled trials
- Source :
- Respirology. 22:1313-1319
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Several long-acting bronchodilators have been developed and are widely used as first-line treatment in patients with stable chronic obstructive pulmonary disease (COPD). However, the initial choice of therapy is still uncertain. The aim of this study was to examine the clinical efficacy and safety of long-acting muscarinic antagonist (LAMA) and long-acting beta2-agonist (LABA) in patients with stable COPD. We searched several databases and manufacturers’ websites to identify relevant randomized clinical trials for meta-analysis. Outcomes of interest were trough forced expiratory volume in 1 s (FEV1), acute exacerbations, transitional dyspnoea index (TDI) score, St George's Respiratory Questionnaire (SGRQ) score and adverse events. Sixteen trials with a total of 22 872 patients were included in this study. Compared with LABA, LAMA were associated with a greater reduction in acute exacerbations (OR: 0.84, 95% CI: 0.74–0.94, P = 0.003) and fewer adverse events (OR: 0.92, 95% CI: 0.86–0.97, P = 0.005). There were no significant differences in trough FEV1, TDI and SGRQ scores. In patients with stable COPD, LAMA were associated with a greater reduction in acute exacerbations and fewer adverse effects compared with LABA.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
COPD
biology
business.industry
Muscarinic antagonist
Lama
biology.organism_classification
medicine.disease
law.invention
03 medical and health sciences
0302 clinical medicine
030228 respiratory system
Randomized controlled trial
law
Anesthesia
Internal medicine
Meta-analysis
Muscarinic acetylcholine receptor
medicine
In patient
030212 general & internal medicine
business
Adverse effect
medicine.drug
Subjects
Details
- ISSN :
- 13237799
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- Respirology
- Accession number :
- edsair.doi...........35e0e56ccaa1b9684fbb66f4896a86b2