Impact of LABA/LAMA combination on exercise endurance and lung hyperinflation in COPD: A pair-wise and network meta-analysis

The ability to exercise is an important clinical outcome in COPD, and the improvement in exercise capacity is recognized to be an important goal in the management of COPD. Therefore, since the current interest in the use of bronchodilators in COPD is gradually shifting towards the dual bronchodilati...

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Bibliographic Details
Published in:Respiratory medicine 2017-08, Vol.129, p.189-198
Main Authors: Calzetta, Luigino, Ora, Josuel, Cavalli, Francesco, Rogliani, Paola, O'Donnell, Denis E., Cazzola, Mario
Format: Article
Language:English
Subjects:
Administration, Inhalation
Adrenergic beta-2 Receptor Agonists - administration & dosage
Adrenergic beta-2 Receptor Agonists - therapeutic use
Adult
Aged
Bias
Bronchodilation
Bronchodilator Agents - therapeutic use
Bronchodilators
Chronic obstructive pulmonary disease
Clinical trials
Combination
COPD
Drug Therapy, Combination - adverse effects
Drug Therapy, Combination - methods
Dyspnea
Exercise
Exercise Tolerance - drug effects
Fatigue tests
Female
Forced Expiratory Volume - drug effects
Humans
Inspiratory Capacity - drug effects
LABA
LAMA
Lung - drug effects
Lung - physiology
Lungs
Male
Meta-analysis
Middle Aged
Muscarinic Antagonists - administration & dosage
Muscarinic Antagonists - therapeutic use
Network Meta-Analysis
Patients
Physical fitness
Pulmonary Disease, Chronic Obstructive - drug therapy
Pulmonary Disease, Chronic Obstructive - physiopathology
Quality
Randomized Controlled Trials as Topic
Respiration
Therapy
Treatment Outcome
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Summary:The ability to exercise is an important clinical outcome in COPD, and the improvement in exercise capacity is recognized to be an important goal in the management of COPD. Therefore, since the current interest in the use of bronchodilators in COPD is gradually shifting towards the dual bronchodilation, we carried out a meta-analysis to evaluate the impact of LABA/LAMA combination on exercise capacity and lung hyperinflation in COPD. RCTs were identified after a search in different databases of published and unpublished trials. The aim of this study was to assess the influence of LABA/LAMA combinations on endurance time (ET) and inspiratory capacity (IC), vs. monocomponents. Eight RCTs including 1632 COPD patients were meta-analysed. LABA/LAMA combinations were significantly (P 
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2017.06.020