Umeclidinium bromide and vilanterol trifenatate in the treatment of COPD ：an overview of systematic review and meta-analysis / 中国药房

ABSTRACT

OBJECTIVE To re-eval uate the systematic review and meta-an alysis of umeclidinium bromide and vilanterol trifenatate（UMEC/VIL）in the treatment of chronic obstructive pulmonary disease （COPD），so as to provide evidence-based basis for the treatment of COPD. METHODS Retrieved from PubMed （Medline），the Cochrane library ，Embase，CNKI，CBM，VIP and Wanfang database ，etc.，the systematic review and meta-analysis of UMEC/VIL in the treatment of COPD were collected from the inception to Apr. 2021. Two reviewers independently screened the literatures and extracted the data. AMSTAR 2 scale，PRISMA statement，and GRADE evaluation system were used to evaluate the methodological quality of the included studies ，the quality of reports and the grade of outcome indexes. The efficacy and safety of UMEC/VIL in the treatment of COPD were reported. RESULTS Six systematic reviews were finally included. The results of AMSTAR 2 scale showed that 1 study was of high quality ， 2 were of medium quality and 3 were of low quality. The score of PRISMA statement was between 21.5 and 27，and the quality of the report was relatively perfect. The results of GRADE evaluation showed that more than 60％ of the 134 outcome indicators were of medium to high quality of evidence. Comparison of effectiveness and safety showed that UMEC/VIL was superior to placebo ， unilateral bronchodilator and salmeterol fluticasone in improving forced expiratory volume in one second （FEV1）trough，FEV1 peak and forced vital capacity （FVC）. In the improvement of transition dyspnea index （TDI），SGRQ and SOBDA scores ，UMEC/ VIL was better than placebo ，unilateral bronchodilator and fluticasone propionate/salme terol. The adverse reaction rate ，acute exacerbation rate ，mortality rate ，withdrawal rate ，pneumonia rate and other negative indicators of UMEC/VIL were not inferior to placebo，unilateral bronchodilator and fluticasone propionate/salme terol. CONCLUSIONS Compared with placebo and unilateral bronchodilator，UMEC/VIL can significantly improve lung function ，symptoms and quality of life ，and has non-inferior effect for negative indicators. Compared with β2 adrenoceptor agonists combined with glucocorticoid ，UMEC/VIL can improve lung function of COPD patients ，but they are similar in other aspects.