| Title |
Comparative efficacy of long-acting muscarinic antagonist monotherapies in COPD: a systematic review and network meta-analysis
|
|---|---|
| Published in |
International Journal of Chronic Obstructive Pulmonary Disease, November 2015
|
| DOI | 10.2147/copd.s92412 |
| Pubmed ID | |
| Authors |
Afisi Segun Ismaila, Eline L Huisman, Yogesh Suresh Punekar, Andreas Karabis |
| Abstract |
Randomized, controlled trials comparing long-acting muscarinic antagonist (LAMA) efficacy in COPD are limited. This network meta-analysis (NMA) assessed the relative efficacy of tiotropium 18 µg once-daily (OD) and newer agents (aclidinium 400 µg twice-daily, glycopyrronium 50 µg OD, and umeclidinium 62.5 µg OD). A systematic literature review identified randomized, controlled trials of adult COPD patients receiving LAMAs. A NMA within a Bayesian framework examined change from baseline in trough forced expiratory volume in 1 second (FEV1), transitional dyspnea index focal score, St George's Respiratory Questionnaire score, and rescue medication use. Twenty-four studies (n=21,311) compared LAMAs with placebo/each other. Aclidinium, glycopyrronium, tiotropium, and umeclidinium, respectively, demonstrated favorable results versus placebo, for change from baseline (95% credible interval) in 12-week trough FEV1 (primary endpoint: 101.40 mL [77.06-125.60]; 117.20 mL [104.50-129.90]; 114.10 mL [103.10-125.20]; 136.70 mL [104.20-169.20]); 24-week trough FEV1 (128.10 mL [84.10-172.00]; 135.80 mL [123.10-148.30]; 106.40 mL [95.45-117.30]; 115.00 mL [74.51-155.30]); 24-week St George's Respiratory Questionnaire score (-4.60 [-6.76 to -2.54]; -3.14 [-3.83 to -2.45]; -2.43 [-2.92 to -1.93]; -4.69 [-7.05 to -2.31]); 24-week transitional dyspnea index score (1.00 [0.41-1.59]; 1.01 [0.79-1.22]; 0.82 [0.62-1.02]; 1.00 [0.49-1.51]); and 24-week rescue medication use (data not available; -0.41 puffs/day [-0.62 to -0.20]; -0.52 puffs/day [-0.74 to -0.30]; -0.30 puffs/day [-0.81 to 0.21]). For 12-week trough FEV1, differences in change from baseline (95% credible interval) were -12.8 mL (-39.39 to 13.93), aclidinium versus tiotropium; 3.08 mL (-7.58 to 13.69), glycopyrronium versus tiotropium; 22.58 mL (-11.58 to 56.97), umeclidinium versus tiotropium; 15.90 mL (-11.60 to 43.15), glycopyrronium versus aclidinium; 35.40 mL (-5.06 to 76.07), umeclidinium versus aclidinium; and 19.50 mL (-15.30 to 54.38), umeclidinium versus glycopyrronium. Limitations included inhaler-related factors and safety; longer-term outcomes were not considered. The new LAMAs studied had at least comparable efficacy to tiotropium, the established class standard. Choice should depend on physician's and patient's preference. |
X Demographics
The data shown below were collected from the profiles of 20 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 3 | 15% |
| Japan | 2 | 10% |
| United States | 2 | 10% |
| Spain | 2 | 10% |
| Poland | 1 | 5% |
| Mexico | 1 | 5% |
| Argentina | 1 | 5% |
| Malaysia | 1 | 5% |
| United Kingdom | 1 | 5% |
| Other | 1 | 5% |
| Unknown | 5 | 25% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 12 | 60% |
| Practitioners (doctors, other healthcare professionals) | 5 | 25% |
| Scientists | 2 | 10% |
| Science communicators (journalists, bloggers, editors) | 1 | 5% |
Mendeley readers
The data shown below were compiled from readership statistics for 92 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 92 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 19 | 21% |
| Student > Master | 13 | 14% |
| Student > Bachelor | 9 | 10% |
| Researcher | 8 | 9% |
| Student > Ph. D. Student | 8 | 9% |
| Other | 21 | 23% |
| Unknown | 14 | 15% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 48 | 52% |
| Pharmacology, Toxicology and Pharmaceutical Science | 16 | 17% |
| Agricultural and Biological Sciences | 3 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Nursing and Health Professions | 2 | 2% |
| Other | 3 | 3% |
| Unknown | 18 | 20% |
Attention Score in Context
This research output has an Altmetric Attention Score of 20. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 November 2022.
All research outputs
#1,859,513
of 25,374,917 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#142
of 2,577 outputs
Outputs of similar age
#26,619
of 294,812 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#5
of 64 outputs
Altmetric has tracked 25,374,917 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,577 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one has done particularly well, scoring higher than 94% of its peers.
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We're also able to compare this research output to 64 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 92% of its contemporaries.