Research Article | Volume: 10, Issue: 10, October, 2020

Three-drug therapy versus two-drug therapy for management of patient-reported manifestations and quality of life in chronic obstructive pulmonary disease patients: A meta-analysis

Ganesh Narayan Sharma,  Syed Aamir Ali,  Birendra Shrivastav,  Aleemuddin Naveed Mohd   
Ganesh Narayan Sharma1, Syed Aamir Ali1, Birendra Shrivastav1, Aleemuddin Naveed Mohd2

1School of Pharmaceutical Sciences, Jaipur National University, Jaipur, Rajasthan, India.

2Department of Pulmonology, Princess Esra Hospital, Shah ali banda, Hyderabad, India.

Open Access   

Published:  Oct 05, 2020

DOI: 10.7324/JAPS.2020.10104
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Abstract

Patient-reported manifestations and quality of life (QoL) data for chronic obstructive pulmonary disease (COPD) drugs are sparse. This study compared three-drug therapy comprising inhaled corticosteroids (ICS), long-acting beta2 agonists (LABA), and long-acting muscarinic antagonists (LAMA) with two-drug therapy (ICS/LABA or LABA/ LAMA) in terms of patient-reported manifestations and QoL. Randomized controlled trials (RCTs) comparing three-drug therapy with two-drug therapy in COPD patients were searched through Pubmed and meta-analyzed. Efficacy endpoints included St George Respiratory Questionnaire (SGRQ) score, SGRQ responders, COPD assessment test (CAT) score, rescue drug use, rescue drug-free days, and adverse events resulting in drug cessation. Three-drug therapy showed improvement in SGRQ scores [mean difference (MD), −1.66; 95% confidence interval (CI), −2.09 to −1.23] and SGRQ responders [Odds Ratio (OR), 1.30; 95% CI, 1.18–1.44] compared to ICS/LABA dual therapy; and SGRQ scores (MD, −1.65; 95%CI, −2.31 to −0.99) and SGRQ responders (OR, 1.20; 95%CI, 1.08–1.34) compared to LABA/ LAMA dual therapy. Similarly, results with CAT scores, rescue medication use, percentage of rescue medication-free days, and adverse events resulting in drug cessation favored the three-drug therapy compared to the two-drug therapy. Three-drug therapy had improved SGRQ scores, CAT scores, reduced rescue medication use, and better QoL.


Keyword:     COPD assessment test (CAT) adverse events St George Respiratory Questionnaire (SGRQ) meta-analysis rescue medication use.

Citation:

Sharma GN, Ali SA, Shrivastav B, Mohd AN. Three-drug therapy versus two-drug therapy for management of patient-reported manifestations and quality of life in chronic obstructive pulmonary disease patients: A meta-analysis. J Appl Pharm Sci, 2020; 10(10):036-049.

Copyright: © The Author(s). This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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