In a new study entitled “Comparative efficacy of combination bronchodilator therapies in COPD: a network meta-analysis,” authors performed a comparative analysis of the efficacy of umeclidinium and vilanterol bronchodilator fixed-dose, when compared to other available dual-bronchodilator combinations, in treating patients with COPD. The study was published in the International Journal of Chronic Obstructive Pulmonary Disease.
Chronic obstructive pulmonary disease (COPD) is a disease characterized by obstruction of the lungs’ airways, with patients complaining from difficulties in breading, cough and mucus production. The disease can escalate into periods defined as acute exacerbations of COPD that are characterized by worsening symptoms – usually increased frequency and severity of shortness of breath and coughing – which can last for a long period of time.
Treatment for COPD is commonly performed with bronchodilators – drugs that open the airways – and recent studies suggest that co-administration of different types of bronchodilators, such as long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) is more effective when compared to single drug treatments. These results recently prompted the commercialization of combined bronchodilators as fixed-doses, such as umeclidinium/vilanterol (UMEC/VI, Anoro® Ellipta®) and indacaterol/glycopyrronium (IND/GLY) (QVA149, Ultibro® Breezhaler®).
In this new study, authors performed a meta-analysis to determine the efficacy of UMEC/VI (dose administration 55/22 μg) with the available dual-combination bronchodilators in COPD patients (with moderate-to-very severe COPD and capable of receiving bronchodilator therapy). They performed a systematic revision of literature of COPD patients’ clinical trials with at least 10 weeks duration, which evaluated combined bronchodilators efficacy in single or separate inhalers. The different bronchodilator setup was evaluated upon changes from baseline in forced expiratory volume in 1 second (FEV1), St George’s Respiratory Questionnaire (SGRQ) total scores, transitional dyspnea index (TDI) focal scores, and the need for rescue medication (determined at 12 weeks and 24 weeks).
In total, authors analyzed 77 articles that reported 26 clinical trials and observed that UMEC/VI efficiency is similar to all other dual fixed or open LABA/LAMA combination bronchodilators (including, IND + TIO, TIO + SAL, TIO + FOR, and QVA149).
The research team highlights that this is the first study comparing the efficacy of several available fixed-dose bronchodilators in COPD patients, and to report the comparable efficacy of UMEC/VI to other available dual-bronchodilator combinations.