Cochrane · systematic review · CD012066
Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) versus LABA plus inhaled corticosteroid (ICS) for stable chronic obstructive pulmonary disease
Fukuda, N, Horita, N, Kaneko, A, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 0 · 0%Moderate 5 · 71.4%High 2 · 28.6%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Show all 2 versionsLong‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) versus LABA plus inhaled corticosteroid (ICS) for stable chronic obstructive pulmonary disease (COPD)
Population: people with stable COPD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Exacerbations (number of people experiencing ≥ 1 exacerbations) Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) vs LABA plus inhaled corticosteroid (ICS) | OR 0.91 [0.78, 1.06] | 13 studies · 20960 participants | Moderate Downgraded: risk of bias, inconsistency |
Serious adverse events (number of people experiencing ≥ 1 SAEs) Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) vs LABA plus inhaled corticosteroid (ICS) | OR 1.02 [0.91, 1.15] | 18 studies · 23183 participants | High |
Quality of life as measured by SGRQ total score change from baseline (MD) Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) vs LABA plus inhaled corticosteroid (ICS) | no estimate extracted | 9 studies · 14437 participants | Moderate Downgraded: risk of bias, inconsistency |
Trough FEV1 change from baseline Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) vs LABA plus inhaled corticosteroid (ICS) | MD 0.07 [0.05, 0.08] | 12 studies · 14681 participants | Moderate Downgraded: risk of bias, inconsistency, indirectness, publication bias |
Pneumonia Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) vs LABA plus inhaled corticosteroid (ICS) | OR 0.61 [0.52, 0.72] | 14 studies · 21829 participants | High |
All‐cause death Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) vs LABA plus inhaled corticosteroid (ICS) | OR 1.35 [1.05, 1.75] | 15 studies · 21510 participants | Moderate Downgraded: risk of bias, imprecision, indirectness, publication bias |
SGRQ total score change from baseline (≥ 4 points, MCID) Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) vs LABA plus inhaled corticosteroid (ICS) | OR 1.06 [0.9, 1.25] | 4 studies · 13614 participants | Moderate Downgraded: risk of bias, inconsistency |