Evidence map›Paper›PMID 39905183›Full record

SynthesisScientific reports2025

Single inhaler with beclometasone, formoterol, and glycopyrronium versus triple therapies in adults with uncontrolled asthma: a systematic review and meta-analysis.

Fulvio Braido, Ioanna Vlachaki, Georgios F Nikolaidis, Dimitrios Tzelis, Ifigeneia Barouma, Alessio Piraino, Alessandra Madoni, Nicola Scichilone

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

8 authors.

Fulvio BraidoRespiratory and Allergy Clinic, IRCCS - Policlinic San Martino, Genoa, Italy.ORCID 0000-0003-2460-4709
Ioanna VlachakiChiesi Farmaceutici S.p.A, Via Palermo 26 A, Parma, 43122, Italy. i.vlachaki@chiesi.com.ORCID 0000-0002-9306-3750
Georgios F NikolaidisIQVIA Ltd, 37 North Wharf Road, W2 AF, London, UK.ORCID 0000-0001-9008-6896
Dimitrios TzelisIQVIA Ltd, 284 Kifissias Ave. 152 32 Halandri, Athens, Greece.ORCID 0000-0002-6524-9048
Ifigeneia BaroumaIQVIA Ltd, 284 Kifissias Ave. 152 32 Halandri, Athens, Greece.ORCID 0000-0001-8906-9570
Alessio PirainoChiesi Farmaceutici S.p.A, Via Palermo 26 A, Parma, 43122, Italy.ORCID 0000-0002-8029-2159
Alessandra MadoniChiesi Farmaceutici S.p.A, Via Palermo 26 A, Parma, 43122, Italy.ORCID 0009-0005-6794-9127
Nicola ScichiloneDepartment of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.ORCID 0000-0001-6400-6573

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recent literature has shown that triple therapy is more effective than dual therapy for individuals with uncontrolled asthma. However, the comparative efficacy between different triple therapies remains unclear. The objective of this study was to determine the comparative efficacy of extra-fine single-inhaler medium-dose (MD) or high-dose (HD) of beclometasone/formoterol/glycopyrronium bromide (BDP/FOR/GLY) compared to other triple therapies in patients whose asthma remains uncontrolled with MD or HD inhaled corticosteroids and long-acting β2-agonists. A systematic literature review identified randomized control trials on adult patients with uncontrolled asthma. Two separate networks were constructed according to patients' previous inhaled-corticosteroid dosage. Network meta-analyses evaluated severe and moderate-to-severe exacerbations, pre-dose forced expiratory volume, and asthma control questionnaire responses at 52 (± 3) weeks. Among single-inhaler triple therapies, MD BDP/FOR/GLY significantly reduced the risk of severe exacerbations (RR [95% CrI] compared to MD fluticasone/umeclidinium/vilanterol: 0.65 [0.49, 0.89]), while HD BDP/FOR/GLY demonstrated an improved trend in reducing severe and moderate-to-severe exacerbations versus HD indacaterol acetate/glycopyrronium bromide/mometasone, fluticasone/umeclidinium/vilanterol, and salmeterol/fluticasone + tiotropium. HD BDP/FOR/GLY and HD BDP/FOR + tiotropium did not differ significantly. Compared to relevant single-inhaler triple therapies, MD and HD BDP/FOR/GLY are associated with a significant benefit or trend for improvement in terms of reducing the rate of severe and moderate-to-severe exacerbations.

Indexed as

Anti-Asthmatic AgentsAsthmaBeclomethasoneFormoterol FumarateGlycopyrrolateAdministration, InhalationAdultDrug Therapy, CombinationHumansNebulizers and VaporizersRandomized Controlled Trials as TopicTreatment OutcomeAnti-Asthmatic AgentsBeclomethasoneFormoterol FumarateGlycopyrrolateAsthmaExacerbationNetwork meta-analysisTriple therapy

Identifiers

PMID39905183
PMCPMC11794625

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.