Efficacy and safety of tiotropium and olodaterol in COPD: a systematic review and meta-analysis
Por:
Miravitlles, M, Urrutia, G, Mathioudakis, AG, Ancochea, J
Publicada:
25 nov 2017
Resumen:
Background: Long-acting bronchodilators are the cornerstone of pharmacologic treatment of COPD. The new combination of long-acting muscarinic antagonist (LAMA) tiotropium (TIO) and long acting beta-agonists (LABA) olodaterol (OLO) has been introduced as fist line therapy for COPD. This article analyses the evidence of efficacy and safety of the TIO/OLO combination.
Methods: A systematic review and metaanalysis of randomized controlled trials (RCT) with a period of treatment of at least 6 weeks, in patients with COPD confirmed by spirometry, comparing combined treatment with TIO/OLO (approved doses only), with any of the mono-components or any other active comparator administered as an inhalator.
Results: A total of 10 Randomized controlled trials (RCT) were identified (N = 10,918). TIO/OLO significantly improved trough FEV1 from baseline to week 12 versus TIO, OLO and LABA/ICS (0.06 L, 0.09 L and between 0.04 and 0.05 L, respectively). TIO/OLO improved transitional dyspnea index (TDI) and St. George's Respiratory Questionnaire (SGRQ) compared with mono-components, with patients more likely to achieve clinically important improvements in TDI (risk ratio [RR]: 1.17, 95% confidence interval [CI]: [1.07, 1.28] versus TIO and RR: 1.14, 95% CI: [1.01, 1.28] versus OLO) and in SGRQ (RR: 1.21, 95% CI: [1.12, 1.30] versus TIO and RR: 1.28, 95% CI: [1.18, 1.40] versus OLO). Patients treated with TIO/OLO showed a significant reduction in the use of rescue medication and no significant differences in frequency of general and serious adverse events were observed between TIO/OLO and mono-components.
Conclusions: Treatment with TIO/OLO provided significant improvements in lung function versus mono-components and LABA/ICS with more patients achieving significant improvements in dyspnea and health status. No differences in adverse events were observed compared with other active treatments.
Filiaciones:
Miravitlles, M:
Hosp Univ Vall Hebron, Pneumol Dept, P Vall Hebron 119-129, ES-08035 Barcelona, Spain
Urrutia, G:
CIBER Epidemiol & Salud Publ CIBERESP, Inst Invest Biomed St Pau IIB St Pau, Barcelona, Spain
Mathioudakis, AG:
Univ Manchester, Univ Hosp South Manchester, Div Infect Immun & Resp Med, Manchester, Lancs, England
Ancochea, J:
Univ Autonoma Madrid, Hosp Univ Princesa, Inst Invest, Pneumol Dept, Madrid, Spain
Gold, Green Published
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