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Volume 149, Issue 5, Pages (May 2016)

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Presentation on theme: "Volume 149, Issue 5, Pages (May 2016)"— Presentation transcript:

1 Volume 149, Issue 5, Pages 1181-1196 (May 2016)
A Systematic Review With Meta-Analysis of Dual Bronchodilation With LAMA/LABA for the Treatment of Stable COPD  Luigino Calzetta, PhD, Paola Rogliani, MD, Maria Gabriella Matera, MD, Mario Cazzola, MD  CHEST  Volume 149, Issue 5, Pages (May 2016) DOI: /j.chest Copyright © 2016 American College of Chest Physicians Terms and Conditions

2 Figure 1 Preferred reporting items for systematic reviews and meta-analyses flow diagram for identifying studies included in the meta-analysis on the influence of long-acting muscarinic antagonist/long-acting β2-agonist combinations vs at least one monocomponent, on trough FEV1, transitional dyspnea index, and St. George’s Respiratory Questionnaire score in COPD patients. CHEST  , DOI: ( /j.chest ) Copyright © 2016 American College of Chest Physicians Terms and Conditions

3 Figure 2 Overall forest plot meta-analysis of the impact of long-acting muscarinic antagonist/long-acting β2-agonist combinations on trough FEV1 and subgroup analysis performed on lower and higher doses of aclidinium (A), formoterol (F), glycopyrronium (G), indacaterol (I), olodaterol (O), tiotropium (T), umeclidinium (U), and vilanterol (V). Because of the scarce number of studies, the subgroup analysis of the glycopyrronium/formoterol combination was performed vs glycopyrronium and formoterol administered as monocomponents. The doses of medications are expressed as micrograms and results as the mean difference (mL) vs monocomponents. CHEST  , DOI: ( /j.chest ) Copyright © 2016 American College of Chest Physicians Terms and Conditions

4 Figure 3 Forest plot meta-analysis of the impact of approved doses of long-acting muscarinic antagonist/long-acting β2-agonist combinations on trough FEV1. Data are expressed as mean difference (mL) vs monocomponents. See Figure 2 legend for expansion of abbreviations. CHEST  , DOI: ( /j.chest ) Copyright © 2016 American College of Chest Physicians Terms and Conditions

5 Figure 4 Forest plot meta-analysis of the impact of long-acting muscarinic antagonist/long-acting β2-agonist combinations on TDI (A) and SGRQ (B). Data are expressed as mean difference vs monocomponents. SGRQ = St. George's Respiratory Questionnaire; TDI = transitional dyspnea index. See Figure 2 legend for expansion of other abbreviations. CHEST  , DOI: ( /j.chest ) Copyright © 2016 American College of Chest Physicians Terms and Conditions

6 Figure 5 Overall (A) and approved doses (B) forest plot meta-analyses of the impact of long-acting muscarinic antagonist/long-acting β2-agonist combinations on cardiac adverse events in COPD patients. Data are expressed as OR vs monocomponents. See Figure 2 legend for expansion of abbreviations. CHEST  , DOI: ( /j.chest ) Copyright © 2016 American College of Chest Physicians Terms and Conditions

7 Figure 6 Funnel plots (left panels) and graphical representation of Egger test (right panels) for the impact on trough FEV1 of approved doses of A/F 400/12 μg (A, B); G/I 15.6/27.5 μg and 50/110 μg (C, D); T/O 5/5 μg (E, F); and U/V 62.5/25 μg (G, H) combinations vs monocomponents. *Y-intercept significantly (P < .1) different from zero. SND = standard normal deviation. See Figure 2 legend for expansion of other abbreviations. CHEST  , DOI: ( /j.chest ) Copyright © 2016 American College of Chest Physicians Terms and Conditions

8 Figure 7 Funnel plots (left panels) and graphical representation of Egger test (right panels) for the impact on cardiac adverse events of approved doses of A/F 400/12 μg (A, B), G/I 15.6/27.5 μg and 50/110 μg (C, D), T/O 5/5 μg (E, F), and U/V 62.5/25 μg (G, H) combinations vs monocomponents. See Figure 2 and 6 legends for expansion of abbreviations. CHEST  , DOI: ( /j.chest ) Copyright © 2016 American College of Chest Physicians Terms and Conditions


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