Inhaled drugs to reduce exacerbations in patients with chronic obstructive pulmonary disease: a network meta-analysis
2009

Inhaled Drugs for COPD Exacerbations

Sample size: 26786 publication Evidence: high

Author Information

Author(s): Milo A Puhan, Lucas M Bachmann, Jos Kleijnen, Gerben ter Riet, Alphons G Kessels

Primary Institution: Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Switzerland

Hypothesis

What is the relative effectiveness of different inhaled drug regimens in reducing exacerbations in patients with chronic obstructive pulmonary disease (COPD)?

Conclusion

No single inhaled drug regimen is more effective than another in reducing exacerbations in COPD patients.

Supporting Evidence

  • All inhaled drug regimens significantly reduced exacerbations compared to placebo.
  • Long-acting anticholinergics and inhaled corticosteroids were effective in patients with FEV1 ≤ 40%.
  • Combination treatment did not show significant improvement over long-acting beta-agonists alone.

Takeaway

Doctors looked at different inhalers to see which one helps people with breathing problems the most, and they found that they all work about the same.

Methodology

A systematic review and network meta-analysis of randomized trials lasting at least 4 weeks.

Limitations

The analysis focused only on exacerbations and lacked individual patient FEV1 data.

Participant Demographics

The study included 26,786 patients with COPD, median age 64 years, 27% had at least one exacerbation.

Statistical Information

P-Value

0.02 for interaction

Confidence Interval

0.64 to 0.80 for long-acting anticholinergics; 0.70 to 0.86 for inhaled corticosteroids

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1741-7015-7-2

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