Once daily long-acting beta2-agonists and long-acting muscarinic antagonists in a combined inhaler versus placebo for chronic obstructive pulmonary disease

Maqsood, Usman; Ho, Terence; Palmer, Karen; Eccles, Fiona; Munavvar, Mohammed; Wang, Ran; Crossingham, Iain; Evans, David

doi:10.1002/14651858.cd012930.pub2

Cited by 20 publications

(11 citation statements)

References 131 publications

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“…Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are two of the world’s leading causes of morbidity and mortality, 1 with a large unmet need for more efficient treatments for COPD beyond smoking cessation, rehabilitation and controller therapy with primarily long-acting bronchodilators and inhaled corticosteroids to alter disease prognosis. 2–4 …”

Section: Introductionmentioning

confidence: 99%

“…Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are two of the world's leading causes of morbidity and mortality, 1 with a large unmet need for more efficient treatments for COPD beyond smoking cessation, rehabilitation and controller therapy with primarily long-acting bronchodilators and inhaled corticosteroids to alter disease prognosis. [2][3][4] In terms of pathophysiology, there is a well-established association between COPD and CVD, where inflammation-driven pulmonary and vascular damage caused by chronic exposure to tobacco smoke accounts for a major part of the common link between the two diseases. It has also been suggested though that COPD may be an individual risk factor for CVD, but this assumption remains disputed.…”

Section: Introductionmentioning

confidence: 99%

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Statins in High-Risk Chronic Obstructive Pulmonary Disease Outpatients: No Impact on Time to First Exacerbation and All-Cause Mortality – The STATUETTE Cohort Study

Damkjær¹,

Håkansson²,

Kallemose³

et al. 2021

COPD

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Background Statins have, due to their anti-inflammatory properties, been suggested to potentially improve chronic obstructive pulmonary disease (COPD) outcomes. We aimed to investigate the effect of statins on time to first exacerbation and all-cause mortality in high-risk COPD outpatients. Methods All outpatients with COPD seen at the Department of Respiratory Medicine, Copenhagen University Hospital Amager and Hvidovre, Denmark in 2016 were identified and followed for 3.5 years in this retrospective, registry-based cohort study of time to first acute exacerbation of COPD (AECOPD) or death. AECOPD was defined as a rescue course of oral corticosteroid and/or hospital admission. The association was estimated using time-varying crude and multivariable Cox proportional hazard regression. Results The cohort comprised 950 COPD outpatients, mean (SD) age 71 (11) years, and FEV1 44% predicted (IQR 33%; 57%). The annual exacerbation rate was 0.88 (1.68) and 211 patients (22%) had a history of hospital admission for AECOPD in the 12 months prior to index date. Three hundred and ninety-three patients (41.4%) were defined as statin users, with 131 (33.3%) having filled the first prescription for statin after index date. Statin use was not associated with reduced risk of AECOPD. When stratifying for moderate and severe exacerbations in a sub-analysis in the same model, statin use did not have an increased HR for exacerbation of either severity (HR = 1.02 (95% CI 0.85to 1.24; p = 0.811) and HR = 1.07 (95% CI 0.89 to 1.29; p = 0.492) respectively). Statin use was not associated with all-cause mortality (HR 1.05 (95% CI, 0.75 to 1.47, p = 0.777)). Conclusion We did not find any association between statin use and risk of AECOPD or all-cause mortality. The result adds to the evidence that an aggressive approach with statin treatment upfront is not beneficial in COPD, unless prescribed according to current guidelines for cardiovascular diseases.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Statins in High-Risk Chronic Obstructive Pulmonary Disease Outpatients: No Impact on Time to First Exacerbation and All-Cause Mortality – The STATUETTE Cohort Study

Damkjær¹,

Håkansson²,

Kallemose³

et al. 2021

COPD

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“…e treatment of COPD has made enormous progress in the past. Inhalation of long-acting bronchodilators or glucocorticoids is the primary treatment for COPD, which has been confirmed to have beneficial effects in reducing exacerbation rates and boosting health conditions [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

The Clinical Efficiency and the Mechanism of Sanzi Yangqin Decoction for Chronic Obstructive Pulmonary Disease

Wang

Kui

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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This work is carried out to evaluate the clinical efficacy of Sanzi Yangqin decoction (SZYQD) treating chronic obstructive pulmonary disease (COPD) and to analyze its mechanism. The clinical efficacy of SZYQD treating COPD was evaluated by meta-analysis, and its mechanism was analyzed by network pharmacology. Molecular docking validation of the main active compounds and the core targets was performed by AutoDock vina software. A cigarette smoke (CS) and LPS-induced COPD model in ICR mice was constructed to confirm the effects of luteolin on COPD. Results showed that SZYQD has a greater benefit on the total effect (OR = 3.85, 95% CI [3.07, 4.83], P = 1 ) in the trial group compared with the control group. The percentage of forced expiratory volume in one second (FEV1%) (MD = 0.5, 95% CI [0.41, 0.59], P < 0.00001 ) and first seconds breathing volume percentage of forced vital capacity (FEV1%/FVC) were improved (MD = 5.97, 95% CI [3.23, 8.71], P < 0.00001 ). There are 27 compounds in SZYQD targeting 104 disease targets related to COPD. PPI network analysis indicated that EGFR, MMP9, PTGS2, MMP2, APP, and ERBB2 may be the core targets for the treatment of COPD. Molecular docking demonstrated that luteolin in SZYQD showed the strongest binding activity to core targets. Experimental results revealed that the expression of COPD-related targets in lung tissue was significantly increased in the COPD group and was improved in the luteolin group. Our data indicated that SZYQD has a curative effect on COPD and luteolin is a candidate compound for COPD treatment by regulating EGFR, MMP9, PTGS2, MMP2, APP, and ERBB2.

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“…1 Patients with COPD have a large unmet need for prognosis-improving therapies besides treatments, such as pulmonary rehabilitation, smoking cessation and maintenance therapy with long-acting bronchodilators and inhaled steroids. 2–4 …”

Section: Introductionmentioning

confidence: 99%

Beta-Blockers in High-Risk Outpatients with Chronic Obstructive Pulmonary Disease are Associated with All-Cause Mortality – The STATUETTE Cohort Study

Damkjær

Ulrik

Godtfredsen

et al. 2021

COPD

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Once daily long-acting beta2-agonists and long-acting muscarinic antagonists in a combined inhaler versus placebo for chronic obstructive pulmonary disease

Abstract: Once daily long-acting beta2-agonists and long-acting muscarinic antagonists in a combined inhaler versus placebo for chronic obstructive pulmonary disease.

Cited by 20 publications

References 131 publications

Statins in High-Risk Chronic Obstructive Pulmonary Disease Outpatients: No Impact on Time to First Exacerbation and All-Cause Mortality – The STATUETTE Cohort Study

Statins in High-Risk Chronic Obstructive Pulmonary Disease Outpatients: No Impact on Time to First Exacerbation and All-Cause Mortality – The STATUETTE Cohort Study

The Clinical Efficiency and the Mechanism of Sanzi Yangqin Decoction for Chronic Obstructive Pulmonary Disease

Beta-Blockers in High-Risk Outpatients with Chronic Obstructive Pulmonary Disease are Associated with All-Cause Mortality – The STATUETTE Cohort Study

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