A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled Corticosteroid

COPD; Inhaled corticosteroid; Mortality

Detalles Bibliográficos
Autores: Miravitlles Fernández, Marc, Calverley, Peter, Bayer, Valentina, Gardev, Asparuh, Dreher, Michael, Verhamme, Katia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:11351/7978
Acceso en línea:https://hdl.handle.net/11351/7978
Access Level:acceso abierto
Palabra clave:Pulmons - Malalties obstructives - Mortalitat
Corticosteroides - Ús terapèutic
Broncodilatadors
DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
Other subheadings::Other subheadings::Other subheadings::Other subheadings::/mortality
CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Peripheral Nervous System Agents::Autonomic Agents::Bronchodilator Agents
CHEMICALS AND DRUGS::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones
ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica
Otros calificadores::Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad
COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::fármacos del sistema nervioso periférico::fármacos del sistema nervioso autónomo::broncodilatadores
COMPUESTOS QUÍMICOS Y DROGAS::hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenal
id ES_03e486afa806ca6dee4bb0f0f9ed9c86
oai_identifier_str oai:recercat.cat:11351/7978
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled Corticosteroid
title A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled Corticosteroid
spellingShingle A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled Corticosteroid
Miravitlles Fernández, Marc
Pulmons - Malalties obstructives - Mortalitat
Corticosteroides - Ús terapèutic
Broncodilatadors
DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
Other subheadings::Other subheadings::Other subheadings::Other subheadings::/mortality
CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Peripheral Nervous System Agents::Autonomic Agents::Bronchodilator Agents
CHEMICALS AND DRUGS::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones
ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica
Otros calificadores::Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad
COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::fármacos del sistema nervioso periférico::fármacos del sistema nervioso autónomo::broncodilatadores
COMPUESTOS QUÍMICOS Y DROGAS::hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenal
title_short A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled Corticosteroid
title_full A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled Corticosteroid
title_fullStr A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled Corticosteroid
title_full_unstemmed A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled Corticosteroid
title_sort A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled Corticosteroid
dc.creator.none.fl_str_mv Miravitlles Fernández, Marc
Calverley, Peter
Bayer, Valentina
Gardev, Asparuh
Dreher, Michael
Verhamme, Katia
author Miravitlles Fernández, Marc
author_facet Miravitlles Fernández, Marc
Calverley, Peter
Bayer, Valentina
Gardev, Asparuh
Dreher, Michael
Verhamme, Katia
author_role author
author2 Calverley, Peter
Bayer, Valentina
Gardev, Asparuh
Dreher, Michael
Verhamme, Katia
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Institut Català de la Salut
[Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. [Verhamme K] Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands. [Calverley PMA] Clinical Science Centre, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK. [Dreher M] Department of Pneumology and Intensive Care Medicine, University Hospital Aachen, Aachen, Germany. [Bayer V] Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA. [Gardev A] Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
Vall d'Hebron Barcelona Hospital Campus
dc.subject.none.fl_str_mv Pulmons - Malalties obstructives - Mortalitat
Corticosteroides - Ús terapèutic
Broncodilatadors
DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
Other subheadings::Other subheadings::Other subheadings::Other subheadings::/mortality
CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Peripheral Nervous System Agents::Autonomic Agents::Bronchodilator Agents
CHEMICALS AND DRUGS::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones
ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica
Otros calificadores::Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad
COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::fármacos del sistema nervioso periférico::fármacos del sistema nervioso autónomo::broncodilatadores
COMPUESTOS QUÍMICOS Y DROGAS::hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenal
topic Pulmons - Malalties obstructives - Mortalitat
Corticosteroides - Ús terapèutic
Broncodilatadors
DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
Other subheadings::Other subheadings::Other subheadings::Other subheadings::/mortality
CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Peripheral Nervous System Agents::Autonomic Agents::Bronchodilator Agents
CHEMICALS AND DRUGS::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones
ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica
Otros calificadores::Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad
COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::fármacos del sistema nervioso periférico::fármacos del sistema nervioso autónomo::broncodilatadores
COMPUESTOS QUÍMICOS Y DROGAS::hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenal
description COPD; Inhaled corticosteroid; Mortality
publishDate 2022
dc.date.none.fl_str_mv 2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11351/7978
url https://hdl.handle.net/11351/7978
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Chronic Obstructive Pulmonary Disease;17
https://doi.org/10.2147/COPD.S350167
dc.rights.none.fl_str_mv Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Dove Medical Press
publisher.none.fl_str_mv Dove Medical Press
dc.source.none.fl_str_mv Scientia
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869402757422645248
spelling A Pooled Analysis of Mortality in Patients with COPD Receiving Dual Bronchodilation with and without Additional Inhaled CorticosteroidMiravitlles Fernández, MarcCalverley, PeterBayer, ValentinaGardev, AsparuhDreher, MichaelVerhamme, KatiaPulmons - Malalties obstructives - MortalitatCorticosteroides - Ús terapèuticBroncodilatadorsDISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic ObstructiveOther subheadings::Other subheadings::Other subheadings::Other subheadings::/mortalityCHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Peripheral Nervous System Agents::Autonomic Agents::Bronchodilator AgentsCHEMICALS AND DRUGS::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex HormonesENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónicaOtros calificadores::Otros calificadores::Otros calificadores::Otros calificadores::/mortalidadCOMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::fármacos del sistema nervioso periférico::fármacos del sistema nervioso autónomo::broncodilatadoresCOMPUESTOS QUÍMICOS Y DROGAS::hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenalCOPD; Inhaled corticosteroid; MortalityMPOC; Corticosteroides inhalats; MortalitatEPOC; Corticosteroides inhalados; MortalidadBackground: Recent studies report a lower mortality rate during treatment with long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA)/inhaled corticosteroid (ICS) versus LAMA/LABA in patients with symptomatic chronic obstructive pulmonary disease (COPD) and a history of exacerbations. Objective: We compared time to all-cause mortality with LAMA/LABA versus LAMA/LABA/ICS in patients with mild-to-very-severe COPD and a predominantly low exacerbation risk. Methods: Data were pooled from six randomized controlled trials (TONADO 1/2, DYNAGITO, WISDOM, UPLIFT and TIOSPIR; LAMA/LABA: n = 3156, LAMA/LABA/ICS: n = 11,891). Analysis was on-treatment and data were censored at 52 weeks. Patients on LAMA/LABA/ICS received ICS prior to study entry, which was not withdrawn at randomization. Patients on LAMA/LABA/ICS were propensity score (PS)-matched to patients on LAMA/LABA who had not previously received ICS; covariates included age, sex, geographical region, smoking status, post-bronchodilator forced expiratory volume in 1 second percent predicted, exacerbation history in previous year, body mass index and time since diagnosis. Time to all-cause mortality was assessed using Cox proportional hazard regression models. Results: After PS matching, 3133 patients on LAMA/LABA and 3133 patients on LAMA/LABA/ICS were analyzed. Fewer than 20% of patients reported ≥ 2 exacerbations in the prior year (LAMA/LABA: 19.1%; LAMA/LABA/ICS: 19.0%). There were 41 (1.3%) deaths on LAMA/LABA and 45 (1.4%) deaths on LAMA/LABA/ICS. No statistically significant difference in time to death was observed between treatment arms (hazard ratio for LAMA/LABA 1.06; 95% confidence intervals 0.68, 1.64; P = 0.806). Sensitivity analyses conducted using different covariates or in an intent-to-treat population showed similar results. Conclusion: This pooled analysis of over 6000 patients with mild-to-very-severe COPD and predominantly low exacerbation risk showed no differences in mortality with LAMA/LABA versus LAMA/LABA/ICS, suggesting that the survival benefit of triple therapy seen in some recent studies may be specific to a high-risk population. This supports current Global Initiative for Chronic Obstructive Lung Disease recommendations that triple therapy should be reserved for the subpopulations of patients who need it the most (eg, those with an eosinophilic phenotype and a high risk of exacerbations) to avoid ICS overuse.Support for this project was provided by Boehringer Ingelheim International GmbH.Dove Medical PressInstitut Català de la Salut[Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. [Verhamme K] Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands. [Calverley PMA] Clinical Science Centre, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK. [Dreher M] Department of Pneumology and Intensive Care Medicine, University Hospital Aachen, Aachen, Germany. [Bayer V] Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA. [Gardev A] Boehringer Ingelheim International GmbH, Ingelheim am Rhein, GermanyVall d'Hebron Barcelona Hospital Campus202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/11351/7978Scientiareponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésInternational Journal of Chronic Obstructive Pulmonary Disease;17https://doi.org/10.2147/COPD.S350167Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:11351/79782026-05-29T05:05:01Z
score 15,81155

Similares en LA Referencia