Introduction: Randomized controlled trials (RCTs) comparing triple therapies (inhaled corticosteroid [ICS], long-acting b 2 -agonist [LABA], and long-acting muscarinic antagonist [LAMA]) for the treatment of chronic obstructive pulmonary disease (COPD) are limited. This network meta-analysis (NMA) investigated the comparative efficacy of single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/ UMEC/VI) versus any triple (ICS/LABA/LAMA) combinations and dual therapies in patients with COPD. Methods: This NMA was conducted on the basis of a systematic literature review (SLR), which identified RCTs in adults aged at least 40 years with COPD. The RCTs compared different ICS/LABA/LAMA combinations or an

Introduction: Few randomised controlled trials (RCTs) have directly compared long-acting muscarinic antagonist/long-acting b 2 -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 monobronchodilator therapies in symptomatic patients with COPD.

We would like to thank you for allowing us the opportunity to respond to the letter received from Marshall et al. and to address the queries raised with respect to our network meta-analysis (NMA) of fluticasone furoate/umeclidinium/ vilanterol (FF/UMEC/VI) triple therapy compared with other therapies for the treatment of chronic obstructive pulmonary disease (COPD) [1].To minimize clinical heterogeneity across COPD studies, we conducted two separate NMAs [1,2] and presented the data in parallel in the same journal. The dual therapy NMA [2] included studies from patients who were mostly symptomatic with infrequent exacerbations to ensure that the long-acting b 2 -agonist (LABA)/ long-acting muscarinic antagonist (LAMA) A. S. Ismaila (&) Value Evidence and Outcomes, GSK,