PMID- 26604734
OWN - NLM
STAT- MEDLINE
DCOM- 20160920
LR  - 20220408
IS  - 1178-2005 (Electronic)
IS  - 1176-9106 (Print)
IS  - 1176-9106 (Linking)
VI  - 10
DP  - 2015
TI  - The efficacy and safety of triple inhaled treatment in patients with chronic 
      obstructive pulmonary disease: a systematic review and meta-analysis using 
      Bayesian methods.
PG  - 2365-76
LID - 10.2147/COPD.S93191 [doi]
AB  - PURPOSE: Although tiotropium (TIO) and inhaled corticosteroid (ICS)/long-acting 
      beta-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. METHODS: We 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. RESULTS: Seven 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. CONCLUSION: Triple therapy with TIO and 
      ICSs/long-acting beta-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.
FAU - Kwak, Min-Sun
AU  - Kwak MS
AD  - Department of Internal Medicine, Healthcare Research Institute, Healthcare System 
      Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea.
FAU - Kim, Eunyoung
AU  - Kim E
AD  - Department of Statistics, Kyungpook National University, Daegu, Republic of 
      Korea.
FAU - Jang, Eun Jin
AU  - Jang EJ
AD  - Department of Information Statistics, Andong National University, Andong, 
      Republic of Korea.
FAU - Kim, Hyun Jung
AU  - Kim HJ
AD  - Department of Preventive Medicine, College of Medicine, Korea University, Seoul, 
      Republic of Korea.
FAU - Lee, Chang-Hoon
AU  - Lee CH
AD  - Department of Internal Medicine, Division of Pulmonary and Critical Care 
      Medicine, Seoul National University College of Medicine, Seoul National 
      University Hospital, Seoul, Republic of Korea.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20151103
PL  - New Zealand
TA  - Int J Chron Obstruct Pulmon Dis
JT  - International journal of chronic obstructive pulmonary disease
JID - 101273481
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Adrenergic beta-2 Receptor Agonists)
RN  - 0 (Bronchodilator Agents)
RN  - 0 (Cholinergic Antagonists)
RN  - 0 (Drug Combinations)
RN  - XX112XZP0J (Tiotropium Bromide)
SB  - IM
MH  - Administration, Inhalation
MH  - Adrenal Cortex Hormones/*administration & dosage/adverse effects
MH  - Adrenergic beta-2 Receptor Agonists/*administration & dosage/adverse effects
MH  - Bayes Theorem
MH  - Bronchodilator Agents/*administration & dosage/adverse effects
MH  - Cholinergic Antagonists/*administration & dosage/adverse effects
MH  - Drug Combinations
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Lung/*drug effects/physiopathology
MH  - Odds Ratio
MH  - Pulmonary Disease, Chronic Obstructive/diagnosis/*drug therapy/physiopathology
MH  - Recovery of Function
MH  - Surveys and Questionnaires
MH  - Tiotropium Bromide/*administration & dosage/adverse effects
MH  - Treatment Outcome
PMC - PMC4639518
OTO - NOTNLM
OT  - chronic obstructive pulmonary disease (COPD)
OT  - inhaled corticosteroids (ICSs)
OT  - inhaled long-acting muscarinic antagonists (LAMAs)
OT  - inhaled long-acting beta2-agonists (LABAs)
EDAT- 2015/11/26 06:00
MHDA- 2016/09/22 06:00
PMCR- 2015/11/03
CRDT- 2015/11/26 06:00
PHST- 2015/11/26 06:00 [entrez]
PHST- 2015/11/26 06:00 [pubmed]
PHST- 2016/09/22 06:00 [medline]
PHST- 2015/11/03 00:00 [pmc-release]
AID - copd-10-2365 [pii]
AID - 10.2147/COPD.S93191 [doi]
PST - epublish
SO  - Int J Chron Obstruct Pulmon Dis. 2015 Nov 3;10:2365-76. doi: 10.2147/COPD.S93191. 
      eCollection 2015.