PMID- 30227433
OWN - NLM
STAT- MEDLINE
DCOM- 20191018
LR  - 20191018
IS  - 1423-0356 (Electronic)
IS  - 0025-7931 (Linking)
VI  - 96
IP  - 4
DP  - 2018
TI  - LABA/LAMA Fixed Dose Combination in Chronic Obstructive Pulmonary Disease: The 
      Impact on Health-Related Quality of Life.
PG  - 370-381
LID - 10.1159/000491673 [doi]
AB  - BACKGROUND: While fixed dose combinations (FDCs) of long-acting beta 2-agonists 
      (LABAs) and long-acting muscarinic antagonists (LAMAs) are increasingly tested on 
      their efficacy in improving lung function, their effectiveness on Patient 
      Reported Outcomes (PROs) such as Health Related Quality of Life (HRQoL) and 
      Health Status (HS) deserve more attention. OBJECTIVES: To review current 
      available evidence about the treatment effect of fixed LABA/LAMA FDCs on HRQoL. 
      METHODS: A systematic literature search for randomized controlled trials (RCTs) 
      about the impact of LABA/LAMA FDCs versus placebo, LABA or LAMA or LABA/ICS on 
      HRQoL in Chronic obstructive pulmonary disease (COPD) patients has been 
      performed. RESULTS: Twenty-eight RCTs (n = 32, 165 COPD patients) investigating 
      the impact of fixed LABA/LAMA combinations on HRQoL were included. Using the St 
      George' s Respiratory Questionnaire, 27 out of 28 trials assessed HRQoL. 
      LABA/LAMA FDCs significantly improved HRQoL versus placebo in 9 out of 11 trials, 
      while change when compared to other LABA or LAMA monocomponents was significantly 
      better in 11 out 24. In 5 out of 6 RCTs having LABA/ICS as comparators, LABA/LAMA 
      FDC had a similar effect and only 1 showed significant improvement in HRQL 
      compared to LABA/ICS FDC. CONCLUSION: LABA/LAMA FDCs may be helpful in improving 
      HRQoL, but because of the heterogeneity of performed trials, strong conclusions 
      cannot be drawn. Moreover, due to the different molecule properties, treatment 
      schedule, and device characteristics of each FDC, a generalized judgment seems 
      inappropriate. Pragmatic trials powered to detect real-life differences in HRQoL 
      and head-to-head comparison are needed to guide clinical practice in terms of 
      PROs.
CI  - (c) 2018 S. Karger AG, Basel.
FAU - Labor, Marina
AU  - Labor M
AD  - Department of Pulmonology, University Hospital Center Osijek, Osijek, Croatia, 
      Faculty of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia.
FAU - Braido, Fulvio
AU  - Braido F
AD  - Department of Internal Medicine, Respiratory Diseases and Allergy Clinic, 
      University of Genova, Azienda Policlinico IRCCs San Martino, Genoa, Italy.
FAU - Bikov, Andras
AU  - Bikov A
AD  - NIHR Manchester Clinical Research Facility, Manchester University NHS Foundation 
      Trust, Manchester, United Kingdom.
FAU - Lahousse, Lies
AU  - Lahousse L
AD  - Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, 
      Ghent, Belgium.
FAU - Rogliani, Paola
AU  - Rogliani P
AD  - Dipartimento di Medicina Sperimentale e Chirurgia Universita di Roma "Tor 
      Vergata,", Roma, Italy.
FAU - Baiardini, Ilaria
AU  - Baiardini I
AD  - Department of Biomedical Sciences, Humanitas University, Milano, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20180918
PL  - Switzerland
TA  - Respiration
JT  - Respiration; international review of thoracic diseases
JID - 0137356
RN  - 0 (Adrenergic beta-2 Receptor Agonists)
RN  - 0 (Drug Combinations)
RN  - 0 (Muscarinic Antagonists)
SB  - IM
MH  - Adrenergic beta-2 Receptor Agonists/*therapeutic use
MH  - Drug Combinations
MH  - Humans
MH  - Muscarinic Antagonists/*therapeutic use
MH  - Pulmonary Disease, Chronic Obstructive/*drug therapy/psychology
MH  - Quality of Life
OTO - NOTNLM
OT  - Chronic obstructive pulmonary disease treatment
OT  - Health-related quality of life
OT  - Long-acting beta 2-agonists /long-acting muscarinic antagonists fixed dose 
      combinations
OT  - Patient reported outcomes
OT  - Randomized controlled trials
EDAT- 2018/09/19 06:00
MHDA- 2019/10/19 06:00
CRDT- 2018/09/19 06:00
PHST- 2018/03/02 00:00 [received]
PHST- 2018/06/26 00:00 [accepted]
PHST- 2018/09/19 06:00 [pubmed]
PHST- 2019/10/19 06:00 [medline]
PHST- 2018/09/19 06:00 [entrez]
AID - 000491673 [pii]
AID - 10.1159/000491673 [doi]
PST - ppublish
SO  - Respiration. 2018;96(4):370-381. doi: 10.1159/000491673. Epub 2018 Sep 18.