A Systematic Review With Meta-Analysis of Dual Bronchodilation With LAMA/LABA for the Treatment of Stable COPD

A Network Meta-Analysis of Long-Acting Muscarinic Antagonist (LAMA) and Long-Acting β2-Agonist (LABA) Combinations in COPD

“…Some RCTs have reported improved lung function outcomes using LAMA ? LABA therapies compared with LABA monotherapy; [15][16][17] these findings are consistent with the conclusions of two recent NMAs, which performed slightly different analyses to that presented in this study [47,48].…”

Umeclidinium/Vilanterol Versus Tiotropium/Olodaterol in Maintenance-Naïve Patients with Moderate Symptomatic Chronic Obstructive Pulmonary Disease: A Post Hoc Analysis

“…Indirect evidence from network meta-analyses indicate an efficacy gradient within the LAMA/LABA class with respect to lung function [14,15,23], and this study, the first head-to-head study of UMEC/VI and TIO/ OLO, confirmed the results of the indirect comparisons in both an all-comer and MN population [21]. The study enrolled patients with a mMRC dyspnea score C 2 [21], indicating they had a significant symptom burden and associated level of impairment in activity at enrollment.…”

“…With a growing body of evidence demonstrating the benefits of dual bronchodilation over monotherapy in a number of clinical settings [4,[9][10][11][12]41], focus is now turning to the relative benefits of different bronchodilator combinations [14]. Indirect evidence from network meta-analyses indicate an efficacy gradient within the LAMA/LABA class with respect to lung function [14,15,23], and this study, the first head-to-head study of UMEC/VI and TIO/ OLO, confirmed the results of the indirect comparisons in both an all-comer and MN population [21].…”

“…A majority of patients who receive LAMA or LABA monotherapy continue to experience ongoing moderate-to-severe dyspnea, regardless of the level of lung function impairment [6], and this symptom persistence can be associated with poor health status, as well as a higher risk for moderate and severe exacerbations and augmented disease management costs [7,8]. There is now a large body of evidence to show that LAMA/LABA combinations consistently improve lung function, breathlessness and health status with no increased incidence of adverse events (AEs), compared with either LABA or LAMA alone [4,[9][10][11][12][13][14][15]. As such, LAMA/LABA combination therapy is recommended as initial therapy in most patients with persistent COPD symptoms [1].…”

A Long-acting Muscarinic Antagonist （LAMA） Added to an Inhaled Corticosteroid and Long-acting Beta-2 Agonist Versus LAMA Alone in Moderate-to-severe Chronic Obstructive Pulmonary Disease:

“…This combination therapy also shows increased safety regarding adverse outcomes including major cardiovascular events compared with monotherapy using an LABA or LAMA alone 3 . Inhaled corticosteroids ICSs and LABA combination therapies ICS/LABA are also recommended in Japanese guidelines for patients with COPD who experience frequent exacerbations 2 .…”