PDF(Pubmed)
Abstract：
UNASSIGNED: Some systematic reviews (SRs) on triple therapy (consisting of long-acting β2-agonist, long-acting muscarinic antagonist, and inhaled corticosteroid, LABA/LAMA/ICS) for chronic obstructive pulmonary disease (COPD) have reported conflicting results. As the number of syntheses increases, the task of identifying and interpreting evidence becomes increasingly complex and demanding.
UNASSIGNED: To provide a comprehensive overview of the efficacy and safety of triple therapy for COPD.
UNASSIGNED: Overview of SRs.
UNASSIGNED: Two independent reviewers conducted comprehensive searches in PubMed, Embase, Web of Science, and the Cochrane Library to identify relevant SRs that compared triple therapy with any non-triple therapy for COPD, from the inception of these databases until 1 June 2023. The AMSTAR 2 and GRADE tools were utilized to assess the quality of the included studies and the evidence for each outcome.
UNASSIGNED: Eighteen SRs encompassing 30 original studies and involving 47,340 participants were analyzed. The overall AMSTAR 2 rating revealed that 3 SRs were of low quality, 13 SRs were of critically low quality, and 2 SRs were of high quality. No high-certainty evidence revealed a significant advantage of triple therapy in improving lung function or reducing acute exacerbations. However, all evidence, including one high certainty, supported the benefits of improving quality of life. Regarding all-cause mortality, no significant difference was found when compared to LAMA or ICS/LABA; however, high-certainty evidence confirmed its effectiveness when compared with LABA/LAMA. Notably, high-certainty evidence indicated that triple therapy was associated with a significant increase in the risk of pneumonia compared to LABA/LAMA.
UNASSIGNED: Triple therapy demonstrated notable benefits in improving lung function, reducing exacerbations, improving quality of life, and reducing all-cause mortality. However, it is important to note that it may also significantly increase the risk of pneumonia.
UNASSIGNED: This overview protocol was prospectively registered with PROSPERO (No. CRD42023431548).
UNASSIGNED: To provide a comprehensive overview of the efficacy and safety of triple therapy for COPD.
UNASSIGNED: Overview of SRs.
UNASSIGNED: Two independent reviewers conducted comprehensive searches in PubMed, Embase, Web of Science, and the Cochrane Library to identify relevant SRs that compared triple therapy with any non-triple therapy for COPD, from the inception of these databases until 1 June 2023. The AMSTAR 2 and GRADE tools were utilized to assess the quality of the included studies and the evidence for each outcome.
UNASSIGNED: Eighteen SRs encompassing 30 original studies and involving 47,340 participants were analyzed. The overall AMSTAR 2 rating revealed that 3 SRs were of low quality, 13 SRs were of critically low quality, and 2 SRs were of high quality. No high-certainty evidence revealed a significant advantage of triple therapy in improving lung function or reducing acute exacerbations. However, all evidence, including one high certainty, supported the benefits of improving quality of life. Regarding all-cause mortality, no significant difference was found when compared to LAMA or ICS/LABA; however, high-certainty evidence confirmed its effectiveness when compared with LABA/LAMA. Notably, high-certainty evidence indicated that triple therapy was associated with a significant increase in the risk of pneumonia compared to LABA/LAMA.
UNASSIGNED: Triple therapy demonstrated notable benefits in improving lung function, reducing exacerbations, improving quality of life, and reducing all-cause mortality. However, it is important to note that it may also significantly increase the risk of pneumonia.
UNASSIGNED: This overview protocol was prospectively registered with PROSPERO (No. CRD42023431548).
摘要：
■关于三联疗法（包括长效β2激动剂，长效毒蕈碱拮抗剂，吸入皮质类固醇，LABA/LAMA/ICS）治疗慢性阻塞性肺疾病（COPD）的结果相互矛盾。随着合成数量的增加，识别和解释证据的任务变得越来越复杂和苛刻。
■对COPD三联疗法的疗效和安全性进行全面概述。
■SRs概述。
■两位独立的审阅者在PubMed中进行了全面的搜索，Embase,WebofScience,和Cochrane图书馆，以确定将三联疗法与任何非三联疗法进行比较的相关SR，从这些数据库开始到2023年6月1日。使用AMSTAR2和GRADE工具评估纳入研究的质量和每个结果的证据。
■分析了18项SR，包括30项原始研究，涉及47,340名参与者。总体AMSTAR2评级显示3个SR质量低，13个SR的质量极低，2个SR是高质量的。没有高确定性证据显示三联疗法在改善肺功能或减少急性加重方面具有显著优势。然而,所有的证据,包括一个高度的确定性，支持提高生活质量的好处。关于全因死亡率，与LAMA或ICS/LABA相比，没有发现显着差异；然而，与LABA/LAMA相比，高确定性证据证实了其有效性。值得注意的是,高确定性证据表明,与LABA/LAMA相比,三联疗法与肺炎风险显著增加相关.
■三联疗法在改善肺功能方面显示出显着益处，减少恶化,提高生活质量,降低全因死亡率。然而,值得注意的是，它也可能显著增加肺炎的风险。
■该概述协议在PROSPERO（编号：CRD42023431548)。
■对COPD三联疗法的疗效和安全性进行全面概述。
■SRs概述。
■两位独立的审阅者在PubMed中进行了全面的搜索，Embase,WebofScience,和Cochrane图书馆，以确定将三联疗法与任何非三联疗法进行比较的相关SR，从这些数据库开始到2023年6月1日。使用AMSTAR2和GRADE工具评估纳入研究的质量和每个结果的证据。
■分析了18项SR，包括30项原始研究，涉及47,340名参与者。总体AMSTAR2评级显示3个SR质量低，13个SR的质量极低，2个SR是高质量的。没有高确定性证据显示三联疗法在改善肺功能或减少急性加重方面具有显著优势。然而,所有的证据,包括一个高度的确定性，支持提高生活质量的好处。关于全因死亡率，与LAMA或ICS/LABA相比，没有发现显着差异；然而，与LABA/LAMA相比，高确定性证据证实了其有效性。值得注意的是,高确定性证据表明,与LABA/LAMA相比,三联疗法与肺炎风险显著增加相关.
■三联疗法在改善肺功能方面显示出显着益处，减少恶化,提高生活质量,降低全因死亡率。然而,值得注意的是，它也可能显著增加肺炎的风险。
■该概述协议在PROSPERO（编号：CRD42023431548)。
