PMID- 34875569
OWN - NLM
STAT- MEDLINE
DCOM- 20220502
LR  - 20220502
IS  - 1527-3288 (Electronic)
IS  - 0147-9563 (Linking)
VI  - 52
DP  - 2022 Mar-Apr
TI  - Safety evaluation of revefenacin at the approved dose in patients with chronic 
      obstructive pulmonary disease: A meta-analysis.
PG  - 52-60
LID - S0147-9563(21)00272-7 [pii]
LID - 10.1016/j.hrtlng.2021.11.004 [doi]
AB  - BACKGROUND: Revefenacin is the first once-daily long-acting muscarinic antagonist 
      (LAMA) for nebulization use in maintenance therapy for patients with chronic 
      obstructive pulmonary disease (COPD). OBJECTIVE: To investigate the safety and 
      tolerability profile of revefenacin at the approved dose (175 mug), compared with 
      placebo and a lower dose (88 mug), for the treatment of COPD. METHODS: Available 
      randomized controlled trials (RCTs), both published and unpublished, were 
      identified via databases. Risk differences (RDs) and risk ratios (RRs), with 
      their corresponding 95% confidence intervals (CIs) were calculated as effect 
      sizes. RESULTS: One unpublished RCT and four articles containing 5 RCTs were 
      included. Combined results showed that there were no significant differences 
      between COPD patients receiving 175 mug revefenacin and those receiving a placebo, 
      concerning the risk of discontinuation due to adverse events (AEs), any all-grade 
      AE, or any serious AE. 175 mug revefenacin also did not significantly increase the 
      risk of antimuscarinic-related AEs, cardiovascular AEs, or 12 commonly reported 
      AEs. Plus, a lower dose of 88 mug was shown to share a comparable safety profile 
      with the 175 mug revefenacin. A non-significant trend towards a decrease in risks 
      of AEs for 175 mug revefenacin was observed. The most frequently reported AE for 
      each group was COPD worsening/exacerbation. CONCLUSION: Revefenacin at the 
      approved dose is generally well-tolerated and safe with minimal AEs, which 
      supports its use as a once-daily nebulized LAMA for the treatment of moderate to 
      severe stable COPD. Additional studies are needed to complete the safety and 
      tolerability profile.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Liu, Baofeng
AU  - Liu B
AD  - Tianjin Fourth Central Hospital, No.1 Zhongshan Road, Tianjin, Hebei 300140, 
      China.
FAU - Zan, Shuangjiang
AU  - Zan S
AD  - Tianjin Fourth Central Hospital, No.1 Zhongshan Road, Tianjin, Hebei 300140, 
      China. Electronic address: zansj213@126.com.
FAU - Luo, Weishun
AU  - Luo W
AD  - Tianjin Fourth Central Hospital, No.1 Zhongshan Road, Tianjin, Hebei 300140, 
      China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20211204
PL  - United States
TA  - Heart Lung
JT  - Heart & lung : the journal of critical care
JID - 0330057
RN  - 0 (Benzamides)
RN  - 0 (Bronchodilator Agents)
RN  - 0 (Carbamates)
RN  - 0 (Muscarinic Antagonists)
RN  - G2AE2VE07O (revefenacin)
SB  - IM
MH  - Administration, Inhalation
MH  - Benzamides
MH  - *Bronchodilator Agents
MH  - Carbamates
MH  - Humans
MH  - Muscarinic Antagonists/adverse effects
MH  - Nebulizers and Vaporizers
MH  - *Pulmonary Disease, Chronic Obstructive/drug therapy
OTO - NOTNLM
OT  - Antimuscarinic agent
OT  - Chronic obstructive pulmonary disease
OT  - Meta-analysis
OT  - Nebulizer
OT  - Safety
COIS- Declaration of Competing Interest None declared.
EDAT- 2021/12/08 06:00
MHDA- 2022/05/03 06:00
CRDT- 2021/12/07 20:25
PHST- 2021/08/29 00:00 [received]
PHST- 2021/11/07 00:00 [accepted]
PHST- 2021/12/08 06:00 [pubmed]
PHST- 2022/05/03 06:00 [medline]
PHST- 2021/12/07 20:25 [entrez]
AID - S0147-9563(21)00272-7 [pii]
AID - 10.1016/j.hrtlng.2021.11.004 [doi]
PST - ppublish
SO  - Heart Lung. 2022 Mar-Apr;52:52-60. doi: 10.1016/j.hrtlng.2021.11.004. Epub 2021 
      Dec 4.