Evidence map›Paper›PMID 40932547›Full record

SynthesisNaunyn-Schmiedeberg's archives of pharmacology2026

A comprehensive systematic review and meta-analysis of ensifentrine in COPD: dose-dependent effects, safety profile, and GRADE-based certainty of evidence.

Amr M Abou Elezz, Kareem Khalefa, Ahmed Farid Gadelmawla, Lamees Taman, Habiba Tariq Saeed, Amr Alaa Azzouz Elkelany, Habiba Abdelhameed Elrefaey, Mohamed Abo Zeid

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Naunyn-Schmiedeberg's archives of pharmacology, 2026. 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. 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

8 authors.

Amr M Abou ElezzFaculty of Medicine, Tanta University, Tanta, Egypt. Amr_31060929@med.tanta.edu.eg.ORCID http://orcid.org/0009-0004-8806-2624
Kareem KhalefaFaculty of Medicine, Tanta University, Tanta, Egypt.
Ahmed Farid GadelmawlaFaculty of Medicine, Menoufia University, Menoufia, Egypt.ORCID http://orcid.org/0000-0002-5802-2291
Lamees TamanFaculty of Medicine, Tanta University, Tanta, Egypt.
Habiba Tariq SaeedFaculty of Medicine, Tanta University, Tanta, Egypt.
Amr Alaa Azzouz ElkelanyFaculty of Medicine, Tanta University, Tanta, Egypt.
Habiba Abdelhameed ElrefaeyFaculty of Medicine, Tanta University, Tanta, Egypt.
Mohamed Abo ZeidFaculty of Medicine, Tanta University, Tanta, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study aims to evaluate the efficacy and safety of ensifentrine in COPD patients. Following the PRISMA guidelines, we conducted a systematic review and meta-analysis, systematically searching PubMed, Web of Science, Scopus, and Cochrane library up to 12 December 2024, for randomized controlled trials (RCTs) evaluating ensifentrine compared to placebo in COPD patients. Eligibility criteria included studies reporting outcomes such as pulmonary function tests, exacerbation rates, and adverse events. Subgroup analysis was conducted based on the timing of outcome evaluation and the doses administered. Additionally, a meta-regression model was employed to evaluate the possible correlations between the Ensifentrine doses and "Average forced expiratory volume (FEV 1)" results and identify the optimal dose. Trial sequential analysis (TSA) was implemented to ensure the conclusiveness of our results. Furthermore, the GRADE approach was used to assess the certainty of evidence and for quality assessment the RoB-2 tool was used. Four RCTs were included in our analysis with a total of 2370 COPD patients. Compared to placebo, ensifentrine 3 mg significantly improved lung functions as measured by change in average FEV1 (MD = 0.09, 95% CI: [0.07 to 0.12]), change in peak FEV1 (0-3 h) (MD = 0.15, 95% CI: [0.13 to 0.18]), and change in morning trough FEV1 (MD = 0.04, 95% CI: [0.02 to 0.07]). Subgrouping based on the administrated dose found that ensifentrine 3 mg showed higher, yet non-significant results compared to the included doses (0.75, 1.5, and 6 mg) in all pulmonary function tests. Moreover, meta-regression revealed a significant dose-response relationship for average FEV1 up to 3 mg, indicating optimal efficacy at 3-mg dose. Ensifentrine also significantly improved quality of life measures, with no significant increase in adverse events across doses. Ensifentrine has proven to be effective in improving lung functions and respiratory symptoms with an acceptable safety profile, thus suggesting a valuable addition to the management of COPD with consideration of potential adverse effects. Nevertheless, further studies with extended long-term follow-up are essential to fully assess the sustained efficacy and safety of ensifentrine and support its optimal therapeutic integration. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Bronchodilator AgentsPulmonary Disease, Chronic ObstructiveDose-Response Relationship, DrugForced Expiratory VolumeHumansRandomized Controlled Trials as TopicBronchodilator AgentsCOPDEnsifentrineFEV1Meta-analysisOhtuvayre

Identifiers

PMID40932547
PMCPMC12901268

What OpenQuestion holds

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Registered trials

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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.