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Sci Rep. 2022;12(1):15698.

Different inhaled corticosteroid doses in triple therapy for chronic obstructive pulmonary disease: systematic review and Bayesian network meta-analysis.

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제1저자 이현우 · 교신저자 이창훈

PMID 36127353 PMC9489688 DOI 10.1038/s41598-022-18353-y IF 4.9 호흡기내과
소속 (3)
  1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, Republic of Korea.
  2. Department of Information Statistics, Andong National University, Andong, Republic of Korea.
  3. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080, Republic of Korea. kauri670@empal.com.

Abstract

A systematic review and Bayesian network meta-analysis is necessary to evaluate the efficacy and safety of triple therapy with different doses of inhaled corticosteroids (ICS) in stable chronic obstructive pulmonary disease (COPD). We selected 26 parallel randomized controlled trials (41,366 patients) comparing triple therapy with ICS/long-acting beta-agonist (LABA), LABA/long-acting muscarinic antagonist (LAMA), and LAMA in patients with stable COPD for ≥ 12 weeks from PubMed, EMBASE, the Cochrane Library, and clinical trial registries (search from inception to June 30, 2022). Triple therapy with high dose (HD)-ICS exhibited a lower risk of total exacerbation in pre-specified subgroups treated for ≥ 48 weeks than that with low dose (LD)-ICS (odds ratio [OR] = 0.66, 95% credible interval [CrI] = 0.52-0.94, low certainty of evidence) or medium dose (MD)-ICS (OR = 0.66, 95% CrI = 0.51-0.94, low certainty of evidence). Triple therapy with HD-ICS exhibited a lower risk of moderate-to-severe exacerbation in pre-specified subgroups with forced expiratory volume in 1 s < 65% (OR = 0.6, 95% CrI = 0.37-0.98, low certainty of evidence) or previous exacerbation history (OR = 0.6, 95% CrI = 0.36-0.999, very low certainty of evidence) than triple therapy with MD-ICS. Triple therapy with HD-ICS may reduce acute exacerbation in patients with COPD treated with other drug classes including triple therapy with LD- or MD-ICS or dual therapies.

© 2022. The Author(s).

Figures

Figure 1
Figure 1 PRISMA flow chart for study inclusion in the systematic review and network meta-analysis.
Figure 2
Figure 2 Network geometry of the 26 eligible randomized controlled trials.

그림 출처: PubMed Central 공개 논문 (PMC9489688)

Conflict of interest statement

The corresponding author (C.H.L.) received a research fund, which is not related to this manuscript, from GSK. Other authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/disclosure-of-interest/ and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

그 밖의 정보
출판 형태
Journal Article, Systematic Review, Network Meta-Analysis
저널
Scientific reports · eISSN 2045-2322
전자 출판
2022-09-20
MeSH
Administration, Inhalation · Adrenal Cortex Hormones · Adrenergic beta-2 Receptor Agonists · Bayes Theorem · Drug Therapy, Combination · Humans · Muscarinic Antagonists* / therapeutic use · Pulmonary Disease, Chronic Obstructive*
Substances
Adrenal Cortex Hormones · Adrenergic beta-2 Receptor Agonists · Muscarinic Antagonists
참고문헌
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