Efficacy and safety of conventional long acting β2- agonists: systematic review and meta-analysis
Background: Chronic obstructive pulmonary disease (COPD) is usually considered one of the leading causes of death worldwide, so finding proper therapeutic strategies for this disease is of high importance. In this meta-analysis, we reviewed the existing literature on the efficacy and safety of conve...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Babol University of Medical Sciences
2016-04-01
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| Series: | Caspian Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://caspjim.com/browse.php?a_code=A-10-84-3&slc_lang=en&sid=1 |
| _version_ | 1818388780707479552 |
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| author | Reza Karbasi-Afshar Jafar Aslani Mostafa Ghanei |
| author_facet | Reza Karbasi-Afshar Jafar Aslani Mostafa Ghanei |
| author_sort | Reza Karbasi-Afshar |
| collection | DOAJ |
| description | Background: Chronic obstructive pulmonary disease (COPD) is usually considered one of the leading causes of death worldwide, so finding proper therapeutic strategies for this disease is of high importance. In this meta-analysis, we reviewed the existing literature on the efficacy and safety of conventional long acting beta agonists (LABAs) in COPD patients.
Methods: We searched MEDLINE and Google scholar to identify relevant articles. We limited data to double-blinded randomized controlled trials (RCTs). Data of 14, 832 COPD subjects including 7540 patients under a β2 agonist (cases) and 7292 taking placebo (controls) retrieved from 20 randomized controlled trials and were enrolled into this meta-analysis. Evaluated outcomes included overall mortality, exacerbations and tolerance to the drug.
Results: The analysis of survival showed no significant difference between those taking LABAs or placebo (relative risk (RR): 0.945, 95% confidence interval (CI): 0.821-1.088, P=0.432). Exacerbation rate, however, was significantly lower among the cases than among the controls (RR: 0.859, 95%CI: 0.800-0.922, p<0.001). Similar observation was detected in analyzing the rate of drug withdrawal in patients of the two groups with patients under placebo having significantly higher rate of drug discontinuation due to adverse events or disease symptoms (RR:0.821, 95% CI: 0.774-0.871; p<0.007).
Conclusion: In conclusion, we found that the use of conventional LABA therapy in COPD patients is associated with a lower exacerbation rate of the disease as well as higher tolerance to the drug, but no survival advantage is expectable. Substitution of LABAs with new agents is recommended. |
| first_indexed | 2024-12-14T04:31:17Z |
| format | Article |
| id | doaj.art-7b503202699c479da22c204bf76a894f |
| institution | Directory Open Access Journal |
| issn | 2008-6164 2008-6172 |
| language | English |
| last_indexed | 2024-12-14T04:31:17Z |
| publishDate | 2016-04-01 |
| publisher | Babol University of Medical Sciences |
| record_format | Article |
| series | Caspian Journal of Internal Medicine |
| spelling | doaj.art-7b503202699c479da22c204bf76a894f2022-12-21T23:17:05ZengBabol University of Medical SciencesCaspian Journal of Internal Medicine2008-61642008-61722016-04-01726470Efficacy and safety of conventional long acting β2- agonists: systematic review and meta-analysisReza Karbasi-Afshar0Jafar Aslani1Mostafa Ghanei2 Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences; Tehran, Iran Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences; Tehran, Iran Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences; Tehran, Iran Background: Chronic obstructive pulmonary disease (COPD) is usually considered one of the leading causes of death worldwide, so finding proper therapeutic strategies for this disease is of high importance. In this meta-analysis, we reviewed the existing literature on the efficacy and safety of conventional long acting beta agonists (LABAs) in COPD patients. Methods: We searched MEDLINE and Google scholar to identify relevant articles. We limited data to double-blinded randomized controlled trials (RCTs). Data of 14, 832 COPD subjects including 7540 patients under a β2 agonist (cases) and 7292 taking placebo (controls) retrieved from 20 randomized controlled trials and were enrolled into this meta-analysis. Evaluated outcomes included overall mortality, exacerbations and tolerance to the drug. Results: The analysis of survival showed no significant difference between those taking LABAs or placebo (relative risk (RR): 0.945, 95% confidence interval (CI): 0.821-1.088, P=0.432). Exacerbation rate, however, was significantly lower among the cases than among the controls (RR: 0.859, 95%CI: 0.800-0.922, p<0.001). Similar observation was detected in analyzing the rate of drug withdrawal in patients of the two groups with patients under placebo having significantly higher rate of drug discontinuation due to adverse events or disease symptoms (RR:0.821, 95% CI: 0.774-0.871; p<0.007). Conclusion: In conclusion, we found that the use of conventional LABA therapy in COPD patients is associated with a lower exacerbation rate of the disease as well as higher tolerance to the drug, but no survival advantage is expectable. Substitution of LABAs with new agents is recommended.http://caspjim.com/browse.php?a_code=A-10-84-3&slc_lang=en&sid=1beta agonist COPD chronic obstructive pulmonary disease meta analysis |
| spellingShingle | Reza Karbasi-Afshar Jafar Aslani Mostafa Ghanei Efficacy and safety of conventional long acting β2- agonists: systematic review and meta-analysis Caspian Journal of Internal Medicine beta agonist COPD chronic obstructive pulmonary disease meta analysis |
| title | Efficacy and safety of conventional long acting β2- agonists: systematic review and meta-analysis |
| title_full | Efficacy and safety of conventional long acting β2- agonists: systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of conventional long acting β2- agonists: systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of conventional long acting β2- agonists: systematic review and meta-analysis |
| title_short | Efficacy and safety of conventional long acting β2- agonists: systematic review and meta-analysis |
| title_sort | efficacy and safety of conventional long acting β2 agonists systematic review and meta analysis |
| topic | beta agonist COPD chronic obstructive pulmonary disease meta analysis |
| url | http://caspjim.com/browse.php?a_code=A-10-84-3&slc_lang=en&sid=1 |
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