Systematic Review And Meta-Analysis Of The Effectiveness And Safety Of Combination Therapy With Glycopirronium-Indacaterol Compared With Other First Line Therapies In Patients With Chronic Obstructive Pulmonary Disease

Abstract

Objectives: To estimate the efficacy and safety of glycopirronium-indacaterol (GLN/IND) as maintenance therapy for moderate to severe chronic obstructive pulmonary disease (COPD) compared to other first-line treatments, through a systematic review and meta-analysis. MethOds: A detailed search was performed in eight electronic databases (MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects (DARE), LILACS, Cochrane Central Register of Randomized Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov) searching for clinical trials that compared efficacy and/or safety of glycopirronium (GLN) alone or GLN/IND as first-line drugs for moderate to severe COPD. Seven functional and quality of life outcomes were collected. An expert panel supported and validated the methodology. Finally, a meta-analysis was performed when the homogeneity of the information permitted. Results: 14.349 references were originally identified, 13.253 were left after eliminating duplicates, and were reviewed by two researchers; 112 full-text articles were retrieved, and finally 13 provided useful information and were included in the analysis. Studies comparing tiotropium (TIO) with GLN didn't show statistically significant differences in efficacy or safety. Studies comparing GLN/IND against TIO, showed statistically significant results, favoring GLN/IND, for "trough FEV1 " (a functional indicator), as well as for, both quality of life scales (Transition Dyspnea Index TDI and Saint Georges Respiratory Questionnaire SGRQ). With respect to safety, GLN/ IND and all first drugs have a similar profile. cOnclusiOns: We conclude that GLN/ IND is more effective than other first-line drugs in the management of moderate to severe COPD, with a similar safety profile.

Efficacy of salmeterol and formoterol combination treatment in mice with chronic obstructive pulmonary disease

“…Statistics indicate that COPD is a major cause of morbidity and mortality worldwide (33). The World Health Organization has predicted that COPD will become the third most common non-cancer cause of mortality worldwide in 2020 (34). Drug therapies for COPD suppress inflammation in the small airways and lung parenchyma (35).…”

Patient-reported outcomes and considerations in the management of COPD: focus on indacaterol/glycopyrronium bromide

“…A meta-analysis on effectiveness and safety of the indacaterol/glycopyrronium combination (IGC) compared with other first-line drugs, particularly tiotropium, is available. Based on the changes in functional indicators and QoL, the authors concluded that IGC was more effective and as safe as tiotropium 17. The whole evidence on efficacy and safety in COPD patients of indacaterol, glycopyronium, and their combination is a key factor in driving the physician’s treatment choice.…”