Comparative Efficacy of Umeclidinium/Vilanterol Versus Other Bronchodilators for the Treatment of Chronic Obstructive Pulmonary Disease: A Network Meta-Analysis

作者：Afisi Ismaila, Katrin Haeussler, Alexandrosz Czira, Vanita Tongbram, Mia Malmenäs, Jatin Agarwal, Maria Nassim, Marija Živković-Gojović, Yunrong Shen, Xinzhe Dong, Maria Duarte, Chris Compton, Claus Vogelmeier, David Halpin · 发表于：Advances in Therapy · 年份：2022 · DOI：10.1007/s12325-022-02234-x · 被引用次数：14 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Respiratory Support and Mechanisms、Inhalation and Respiratory Drug Delivery

Few randomised controlled trials (RCTs) have directly compared long-acting muscarinic antagonist/long-acting β2-agonist (LAMA/LABA) dual maintenance therapies for patients with chronic obstructive pulmonary disease (COPD). This systematic literature review and network meta-analysis (NMA) compared the efficacy of umeclidinium/vilanterol (UMEC/VI) versus other dual and mono-bronchodilator therapies in symptomatic patients with COPD. A systematic literature review (October 2015–November 2020) was performed to identify RCTs ≥ 8 weeks long in adult patients with COPD that compared LAMA/LABA combinations against any long-acting bronchodilator-containing dual therapy or monotherapy. Data extracted on changes from baseline in trough forced expiratory volume in 1 s (FEV1), St George’s Respiratory Questionnaire (SGRQ) total score, Transitional Dyspnoea Index (TDI) focal score, rescue medication use and moderate/severe exacerbation rate were analysed using an NMA in a frequentist framework. The primary comparison was at 24 weeks. Fixed effects model results are presented. The NMA included 69 full-length publications (including 10 GSK clinical study reports) reporting 49 studies. At 24 weeks, UMEC/VI provided statistically significant greater improvements in FEV1 versus all dual therapy and monotherapy comparators. UMEC/VI provided similar improvements in SGRQ total score compared with all other LAMA/LABAs, and significantly greater improvements versus UMEC 125 μg, glycopyrronium 50 μg, ...