Efficacy of Budesonide/Glycopyrronium/Formoterol Fumarate Metered Dose Inhaler (BGF MDI) Versus Other Inhaled Corticosteroid/Long-Acting Muscarinic Antagonist/Long-Acting β

Published
April 27, 2020
Journal
Advances in therapy
PICOID
ccff2091
DOI
Citations
14
Keywords
Chronic obstructive pulmonary disease, Exacerbations, Inhaled corticosteroid, Long-acting muscarinic antagonist, Long-acting β2-agonist, Lung function, Network meta-analysis, Patient-reported outcomes, Triple therapy
Copyright
Patients/Population/Participants

patients with moderate to very severe COPD

Intervention

triple inhaled corticosteroid/long-acting muscarinic antagonist/long-acting β2 agonist

Comparison

ICS/LABA dual combinations

Outcome

exacerbation rate per patient per year, changes from baseline in pre-dose trough forced expiratory volume in 1 s (FEV1)

Abstract

P
I
C
O

Triple inhaled corticosteroid/long-acting muscarinic antagonist/long-acting β A systematic literature review was conducted to identify randomized controlled trials of at least 10-week duration, including at least one fixed-dose or open combination triple therapy arm, in patients with moderate to very severe COPD. Studies were assessed for methodological quality and risk of bias. A three-level hierarchical Bayesian NMA model was used to determine the exacerbation rate per patient per year as well as the following outcomes at week 24: changes from baseline in pre-dose trough forced expiratory volume in 1 s (FEV Eighteen studies (n = 29,232 patients) contributed to the NMA. ICS/LABA dual combinations were combined as a single treatment group to create a connected network. Across all outcomes, there were no statistically significant differences between BGF MDI and other triple ICS/LAMA/LABA fixed-dose (fluticasone furoate/umeclidinium/vilanterol and beclomethasone dipropionate/glycopyrronium/formoterol fumarate) and open combinations with data available within the network. Results from sensitivity analyses and meta-regression were consistent with the base-case scenario. This NMA suggested that BGF MDI has comparable efficacy to other ICS/LAMA/LABA fixed-dose and open triple combination therapies in reducing exacerbations and improving lung function and symptoms in patients with moderate to very severe COPD. Further research is warranted as additional evidence regarding triple therapies, especially fixed-dose combinations, becomes available.

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