The efficacy and safety of additional treatment with short-acting muscarinic antagonist combined with long-acting beta-2 agonist in stable patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis.

IF 3.5 3区医学 Q2 RESPIRATORY SYSTEM

Chronic Respiratory Disease Pub Date : 2023-01-01 DOI:10.1177/14799731231166008

Kazuya Tanimura, Susumu Sato, Yukio Fujita, Yoshifumi Yamamoto, Takashi Hajiro, Nobuyuki Horita, Tomotaka Kawayama, Shigeo Muro

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引用次数: 1

Abstract

Background: The rationale for additional treatment with short-acting bronchodilators combined with long-acting bronchodilators for patients with chronic obstructive pulmonary disease (COPD) is not adequately studied.

Methods: We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of a short-acting muscarinic antagonist (SAMA) therapy combined with a long-acting beta-2 agonist (LABA) in patients with stable COPD. Pulmonary function, dyspnea, health-related quality of life, exercise tolerance, physical activity, exacerbations of COPD, and adverse events during regular use were set as outcomes of interest.

Results: We included five controlled trials including two sets of publicly available online data without article publications for the meta-analysis. Additional use of SAMA plus LABA showed a significant improvement in the peak response in FEV₁ (mean difference (MD) 98.70 mL, p < .00001), transitional dyspnea index score (MD .85, p = .02), and St George's Respiratory Questionnaire score (MD -2.00, p = .008) compared to LABA treatment. There was no significant difference in the risk of exacerbation of COPD (p = .20) and only a slight trend of increased severe adverse events (OR: 2.16, p = .08) and cardiovascular events (OR: 2.38, p = .06).

Conclusion: Additional treatment with SAMA combined with LABA could be a feasible choice due to its efficacy and safety.

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短效毒蕈碱拮抗剂联合长效β -2激动剂治疗稳定型慢性阻塞性肺疾病患者的疗效和安全性:一项系统回顾和荟萃分析

背景:短效支气管扩张剂联合长效支气管扩张剂对慢性阻塞性肺疾病(COPD)患者进行额外治疗的理由尚未得到充分研究。方法:我们进行了系统回顾和荟萃分析，以评估短效毒蕈碱拮抗剂(SAMA)联合长效β -2激动剂(LABA)治疗稳定期COPD患者的疗效和安全性。肺功能、呼吸困难、健康相关生活质量、运动耐量、体力活动、COPD恶化和常规使用期间的不良事件被设定为感兴趣的结果。结果:我们纳入了五项对照试验，其中包括两组公开可获得的在线数据，但没有发表文章进行meta分析。与LABA治疗相比，额外使用SAMA + LABA治疗在FEV1(平均差值(MD) 98.70 mL, p < 0.00001)、过渡性呼吸困难指数评分(MD) 0.85, p = 0.02)和圣乔治呼吸问卷评分(MD -2.00, p = 0.008)的峰值反应方面均有显著改善。两组COPD恶化风险无显著差异(p = 0.20)，严重不良事件(OR: 2.16, p = 0.08)和心血管事件(OR: 2.38, p = 0.06)略有增加趋势。结论:SAMA联合LABA是一种有效、安全的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chronic Respiratory Disease RESPIRATORY SYSTEM-

CiteScore

5.90

自引率

7.30%

发文量

审稿时长

11 weeks

期刊介绍： Chronic Respiratory Disease is a peer-reviewed, open access, scholarly journal, created in response to the rising incidence of chronic respiratory diseases worldwide. It publishes high quality research papers and original articles that have immediate relevance to clinical practice and its multi-disciplinary perspective reflects the nature of modern treatment. The journal provides a high quality, multi-disciplinary focus for the publication of original papers, reviews and commentary in the broad area of chronic respiratory disease, particularly its treatment and management.