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Advances in Therapy
Published in: Advances in Therapy 11/2022

Open Access 20-07-2022 | Umeclidinium | Original Research

Comparative Efficacy of Umeclidinium/Vilanterol Versus Other Bronchodilators for the Treatment of Chronic Obstructive Pulmonary Disease: A Network Meta-Analysis

Authors: Afisi S. Ismaila, Katrin Haeussler, Alexandrosz Czira, Vanita Tongbram, Mia Malmenäs, Jatin Agarwal, Maria Nassim, Marija Živković-Gojović, Yunrong Shen, Xinzhe Dong, Maria Duarte, Chris Compton, Claus F. Vogelmeier, David M. G. Halpin

Published in: Advances in Therapy | Issue 11/2022

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Abstract

Introduction

Few randomised controlled trials (RCTs) have directly compared long-acting muscarinic antagonist/long-acting β2-agonist (LAMA/LABA) dual maintenance therapies for patients with chronic obstructive pulmonary disease (COPD). This systematic literature review and network meta-analysis (NMA) compared the efficacy of umeclidinium/vilanterol (UMEC/VI) versus other dual and mono-bronchodilator therapies in symptomatic patients with COPD.

Methods

A systematic literature review (October 2015–November 2020) was performed to identify RCTs ≥ 8 weeks long in adult patients with COPD that compared LAMA/LABA combinations against any long-acting bronchodilator-containing dual therapy or monotherapy. Data extracted on changes from baseline in trough forced expiratory volume in 1 s (FEV1), St George’s Respiratory Questionnaire (SGRQ) total score, Transitional Dyspnoea Index (TDI) focal score, rescue medication use and moderate/severe exacerbation rate were analysed using an NMA in a frequentist framework. The primary comparison was at 24 weeks. Fixed effects model results are presented.

Results

The NMA included 69 full-length publications (including 10 GSK clinical study reports) reporting 49 studies. At 24 weeks, UMEC/VI provided statistically significant greater improvements in FEV1 versus all dual therapy and monotherapy comparators. UMEC/VI provided similar improvements in SGRQ total score compared with all other LAMA/LABAs, and significantly greater improvements versus UMEC 125 μg, glycopyrronium 50 μg, glycopyrronium 18 μg, tiotropium 18 μg and salmeterol 50 μg. UMEC/VI also provided significantly better outcomes versus some comparators for TDI focal score, rescue medication use, annualised moderate/severe exacerbation rate, and time to first moderate/severe exacerbation.

Conclusion

UMEC/VI provided generally better outcomes compared with LAMA or LABA monotherapies, and consistent improvements in lung function (measured by change from baseline in trough FEV1 at 24 weeks) versus dual therapies. Treatment with UMEC/VI may improve outcomes for symptomatic patients with COPD compared with alternative maintenance treatments.
Appendix
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Metadata
Title
Comparative Efficacy of Umeclidinium/Vilanterol Versus Other Bronchodilators for the Treatment of Chronic Obstructive Pulmonary Disease: A Network Meta-Analysis
Authors
Afisi S. Ismaila
Katrin Haeussler
Alexandrosz Czira
Vanita Tongbram
Mia Malmenäs
Jatin Agarwal
Maria Nassim
Marija Živković-Gojović
Yunrong Shen
Xinzhe Dong
Maria Duarte
Chris Compton
Claus F. Vogelmeier
David M. G. Halpin
Publication date
20-07-2022
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 11/2022
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-022-02234-x

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