Evidence map›Paper›PMID 26604734›Full record

SynthesisInternational journal of chronic obstructive pulmonary disease2015

The efficacy and safety of triple inhaled treatment in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis using Bayesian methods.

Min-Sun Kwak, Eunyoung Kim, Eun Jin Jang, Hyun Jung Kim, Chang-Hoon Lee

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of chronic obstructive pulmonary disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Article
  7. Inhaled corticosteroids for chronic obstructive pulmonary disease: what is their role in therapy?International journal of chronic obstructive pulmonary disease · 2018
    Review
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Min-Sun KwakDepartment of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea.
Eunyoung KimDepartment of Statistics, Kyungpook National University, Daegu, Republic of Korea.
Eun Jin JangDepartment of Information Statistics, Andong National University, Andong, Republic of Korea.
Hyun Jung KimDepartment of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.
Chang-Hoon LeeDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAlthough tiotropium (TIO) and inhaled corticosteroid (ICS)/long-acting β-agonists are frequently prescribed together, the efficacy of "triple therapy" has not been scientifically demonstrated. We conducted a systematic review and meta-analysis using Bayesian methods to compare triple therapy and TIO monotherapy.

methodsWe searched the MEDLINE, EMBASE, and Cochrane Library databases for randomized controlled trials comparing the efficacy and safety of triple therapy and TIO monotherapy in patients with chronic obstructive pulmonary disease (COPD). We conducted a meta-analysis to compare the effectiveness and safety of triple therapy and TIO monotherapy using Bayesian random effects models.

resultsSeven trials were included, and the risk of bias in the majority of the studies was acceptable. There were no statistically significant differences in the incidence of death and acute exacerbation of disease in the triple therapy and TIO monotherapy groups. Triple therapy improved the prebronchodilator forced expiratory volume in 1 second (mean difference [MD], 63.68 mL; 95% credible interval [CrI], 45.29-82.73), and patients receiving triple therapy showed more improvement in St George Respiratory Questionnaire scores (MD, -3.11 points; 95% CrI, -6.00 to -0.80) than patients receiving TIO monotherapy. However, both of these differences were lower than the minimal clinically important difference (MCID). No excessive adverse effects were reported in triple therapy group.

conclusionTriple therapy with TIO and ICSs/long-acting β-agonists was only slightly more efficacious than TIO monotherapy in treating patients with COPD. Further investigations into the efficacy of new inhaled drugs are needed.

Indexed as

Administration, InhalationAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsBayes TheoremBronchodilator AgentsCholinergic AntagonistsDrug CombinationsForced Expiratory VolumeHumansLungOdds RatioPulmonary Disease, Chronic ObstructiveRecovery of FunctionSurveys and QuestionnairesTiotropium BromideTreatment OutcomeAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsBronchodilator AgentsCholinergic AntagonistsDrug CombinationsTiotropium Bromidechronic obstructive pulmonary disease (COPD)inhaled corticosteroids (ICSs)inhaled long-acting muscarinic antagonists (LAMAs)inhaled long-acting β2-agonists (LABAs)

Identifiers

PMID26604734
PMCPMC4639518

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.