Unknown

Dataset Information

0

Comparative efficacy of aclidinium versus glycopyrronium and tiotropium, as maintenance treatment of moderate to severe COPD patients: a systematic review and network meta-analysis.


ABSTRACT: Aclidinium bromide is a new long-acting muscarinic antagonist (LAMA) indicated for maintenance bronchodilator treatment of chronic obstructive pulmonary disease (COPD). The efficacy of aclidinium was compared with tiotropium and glycopyrronium, using a network meta-analysis (NMA) of randomized controlled trials (RCTs) in moderate-to-severe COPD patients.A systematic review was performed to identify RCTs evaluating aclidinium 400 ?g twice daily (BID), glycopyrronium 50 ?g once daily (OD), tiotropium 18 ?g OD, or tiotropium 5 ?g OD in adults with moderate-to-severe COPD. The outcomes of interest were: trough forced expiratory volume in 1 second (FEV1); St George's Respiratory Questionnaire (SGRQ) total score and proportion of patients achieving ?4 unit change; Transition Dyspnea Index (TDI) focal score and proportion of patients achieving ?1 point change. The results were synthesized by means of a Bayesian NMA.Twenty-one studies (22,542 patients) were included: aclidinium 400 ?g BID (three studies); tiotropium 5 ?g OD (three studies); tiotropium 18 ?g OD (13 studies); and glycopyrronium 50 ?g OD (two studies). Regarding trough FEV1 at 24 weeks, aclidinium demonstrated comparable efficacy to tiotropium 5 ?g (difference in change from baseline [CFB]), (0.02 L [95% credible interval CrI -0.05, 0.09]); tiotropium 18 ?g (0.02 L [95% CrI -0.05, 0.08]); and glycopyrronium (0.00 L [95% CrI -0.07, 0.07]). Aclidinium resulted in higher improvement in SGRQ score at 24 weeks, compared to tiotropium 5 ?g (difference in CFB, -2.44 [95% CrI -4.82, -0.05]); and comparable results to tiotropium 18 ?g (-1.80 [95% CrI -4.52, 0.14]) and glycopyrronium (-1.52 [95% CrI -4.08, 1.03]). Improvements in TDI score were comparable for all treatments.Maintenance treatment with aclidinium 400 ?g BID is expected to produce similar improvements in lung function, health-related quality of life, and dyspnea compared to tiotropium 5 ?g OD; tiotropium 18 ?g OD; and glycopyrronium 50 ?g OD.

PROVIDER: S-EPMC3772873 | BioStudies | 2013-01-01T00:00:00Z

REPOSITORIES: biostudies

Similar Datasets

2013-01-01 | S-EPMC4014806 | BioStudies
2015-01-01 | S-EPMC4655912 | BioStudies
2016-01-01 | S-EPMC4833795 | BioStudies
2017-01-01 | S-EPMC5476673 | BioStudies
2019-01-01 | S-EPMC6343749 | BioStudies
2012-01-01 | S-EPMC3512498 | BioStudies
2014-01-01 | S-EPMC3907130 | BioStudies
2012-01-01 | S-EPMC3528484 | BioStudies
2020-01-01 | S-EPMC7361488 | BioStudies
2013-01-01 | S-EPMC3787813 | BioStudies