#Trelegy ics laba lama save trial

#Trelegy ics laba lama save trial

Recently, a large new ETHOS trial has been performed to clarify the ICS add-on effects. Therefore, the evidence from these systematic reviews is mainly from one large randomized controlled trial (RCT), the IMPACT study which was performed for 52 weeks using a single inhaler device, and it remains unclear whether the ICS add-on treatment is beneficial or not. However, the included trials contain several biases, such as not using a single inhalation device, using different LABA between the comparison groups or a short evaluation duration of only 24 weeks. Until now, five systematic reviews have been performed to evaluate the efficacy and safety of ICS add-on to LAMA/LABA treatment. Therefore, a decision for the long-term use of ICS should be based on the total benefit for such patients. However, in severe COPD patients, the additional treatment of ICS could increase the incidence of pneumonia. Recently, a reduction of the mortality has also been shown by this treatment. If the patients have severe symptoms and a history of exacerbations, the addition of inhaled corticosteroid (ICS) to long-acting muscarinic antagonist (LAMA) and long-acting beta-agonist (LABA) combination therapy has been recommended because it lowers the incidence of exacerbations. To reduce the symptoms and the exacerbation, single or dual inhaled bronchodilators are recommended for the treatment depending on the severity. The symptoms include dyspnea, cough and sputum production and worsen during exacerbations of COPD, which are associated with accelerated mortality. Comparison between ICS add-on and ICS withdrawal protocol: mortality.Ĭhronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world. Comparison between ICS add-on and ICS withdrawal protocol: pneumonia events. Comparison between ICS add-on and ICS withdrawal protocol: serious adverse events. Comparison between ICS add-on and ICS withdrawal protocol: total adverse events. Comparison between ICS add-on and ICS withdrawal protocol: trough FEV 1. Comparison between ICS add-on and ICS withdrawal protocol: change from baseline in TDI score. Comparison between ICS add-on and ICS withdrawal protocol: change from baseline in SGRQ score. Efficacy of ICS withdrawal from ICS/LAMA/LABA on exacerbations. Sub-analysis of mortality by history of exacerbations and CAT score. Sub-analysis of pneumonia events by history of exacerbations and CAT score. Sub-analysis of trough FEV 1 by history of exacerbations and CAT score. Sub-analysis of TDI sore by history of exacerbations and CAT score. Sub-analysis of SGRQ score by history of exacerbations and CAT score. Sub-analysis of exacerbations by history of exacerbations and CAT score. Sub-analysis of cause of mortality: cardiovascular events. Efficacy of ICS add-on to LAMA/LABA on serious adverse events. Efficacy of ICS add-on to LAMA/LABA on total adverse events. N.S. = not significant N.A. = not available from the original papers. Comparison of exacerbation rate in each trial. Summary of findings for the main comparison. Sub-analysis of trough FEV 1 by baseline blood eosinophil count (descriptive analysis). Sub-analysis of exacerbations by baseline blood eosinophil count (descriptive analysis). Baseline blood eosinophil count and moderate to severe COPD exacerbations in the past 12 months. Characteristics of included studies for the analysis of each outcome. List of studies excluded from the analysis. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Īdditional file 1: Table S1. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.