Long-acting dual bronchodilator therapy (indacaterol/glycopyrronium) versus nebulized short-acting dual bronchodilator (salbutamol/ipratropium) in chronic obstructive pulmonary disease: A double-blind, randomized, placebo-controlled trial

Geffen, Wouter H. van; Carpaij, Orestes A; Westbroek, Lotte F; Seigers, Dianne; Niemeijer, Alice; Vonk, Judith M.; Kerstjens, Huib A. M.

doi:10.1016/j.rmed.2020.106064

Cited by 3 publications

(3 citation statements)

References 15 publications

(15 reference statements)

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“…Combination therapy of SABA and SAMA is reported to show a faster onset of action and greater peak bronchodilation compared to that of LAMA and LABA. 26 In the present meta-analysis, compared to placebo plus LABA treatment, additional therapy with SAMA plus LABA treatment significantly improved not only the peak response of FEV1 in a single inhalation but also TDI score and SGRQ score in regular use. The improvement did not reach their MCID but was equivalent to them for pulmonary function and dyspnea.…”

Section: Discussionmentioning

confidence: 55%

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

et al. 2023

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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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Section: Discussionmentioning

confidence: 55%

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

et al. 2023

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“… 37 , 38 Compared with nebulised SABA/SAMA, effect on FEV1 is not superior over 6h with a slower reaching of lower peak FEV1 in dry powder with LABA/LAMA. 39 …”

Section: Resultsmentioning

confidence: 99%

“…37,38 Compared with nebulised SABA/SAMA, effect on FEV1 is not superior over 6h with a slower reaching of lower peak FEV1 in dry powder with LABA/LAMA. 39 ICS/LABA. Cochrane reviews suggest that ICS/LABA reduces exacerbations and potentially improves mortality, lung function, symptoms and QoL, compared with ICS, LABA or usual care.…”

Section: Pharmacological Managementmentioning

confidence: 99%

Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review

Chapman

Boland

et al. 2022

Palliat Med

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Background: Patients with chronic obstructive pulmonary disease (COPD) face limited treatment options and inadequate access to palliative care. Aim: To provide a pragmatic overview of clinical guidelines and produce evidence-based recommendations for severe COPD. Interventions for which there is inconsistent evidence to support their use and areas requiring further research were identified. Design: Practice review of guidelines supported by scoping review methodology to examine the evidence reporting the use of guideline-recommended interventions. Data sources: An electronic search was undertaken in MEDLINE, EMBASE, PsycINFO, CINAHL and The Cochrane Database of Systematic Reviews, complemented by web searching for guidelines and publications providing primary evidence (July 2021). Guidelines published within the last 5 years and evidence in the last 10 years were included. Results: Severe COPD should be managed using a multidisciplinary approach with a holistic assessment. For stable patients, long-acting beta-agonist/long-acting muscarinic antagonist and pulmonary rehabilitation are recommended. Low dose opioids, self-management, handheld fan and nutritional support may provide small benefits, whereas routine corticosteroids should be avoided. For COPD exacerbations, systematic corticosteroids, non-invasive ventilation and exacerbation action plans are recommended. Short-acting inhaled beta-agonists and antibiotics may be considered but pulmonary rehabilitation should be avoided during hospitalisation. Long term oxygen therapy is only recommended for patients with chronic severe hypoxaemia. Short-acting anticholinergic inhalers, nebulised opioids, oral theophylline or telehealth are not recommended. Conclusions: Recommended interventions by guidelines are not always supported by high-quality evidence. Further research is required on efficacy and safety of inhaled corticosteroids, antidepressants, benzodiazepines, mucolytics, relaxation and breathing exercises.

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Inhaled corticosteroids with combination inhaled long-acting beta2-agonists and long-acting muscarinic antagonists for chronic obstructive pulmonary disease

van Geffen,

Tan,

Walters

et al. 2023

Cochrane Database of Systematic Reviews

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Long-acting dual bronchodilator therapy (indacaterol/glycopyrronium) versus nebulized short-acting dual bronchodilator (salbutamol/ipratropium) in chronic obstructive pulmonary disease: A double-blind, randomized, placebo-controlled trial

Cited by 3 publications

References 15 publications

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

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

Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review

Inhaled corticosteroids with combination inhaled long-acting beta2-agonists and long-acting muscarinic antagonists for chronic obstructive pulmonary disease

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