tailieunhanh - Báo cáo y học: "The effects of long-acting bronchodilators on total mortality in patients with stable chronic obstructive pulmonary disease"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài:"The effects of long-acting bronchodilators on total mortality in patients with stable chronic obstructive pulmonary disease. | Kliber et al. Respiratory Research 2010 11 56 http content 11 1 56 RESPIRATORY RESEARCH REVIEW Open Access The effects of long-acting bronchodilators on total mortality in patients with stable chronic obstructive pulmonary disease Agnes Kliber 1 Larry D Lynd2 3 and Don D Sin 1 3 4 Abstract Background Chronic obstructive pulmonary disease COPD is the 4th leading cause of mortality worldwide. Long-acting bronchodilators are considered first line therapies for patients with COPD but their effects on mortality are not well known. We performed a comprehensive systematic review and meta-analysis to evaluate the effects of long-acting bronchodilators on total mortality in stable COPD. Methods Using MEDLINE EMBASE and Cochrane Systematic Review databases we identified high quality randomized controlled trials of tiotropium formoterol salmeterol formoterol budesonide or salmeterol fluticasone in COPD that had a follow-up of 6 months or longer and reported on total mortality. Two reviewers independently abstracted data from the original trials and disagreements were resolved by iteration and consensus. Results Twenty-seven trials that included 30 495 patients were included in the review. Relative risk RR for total mortality was calculated for each of the study and pooled together using a random-effects model. The combination of inhaled corticosteroid ICS and long-acting beta-2 agonist LABA therapy was associated with reduced total mortality compared with placebo RR p . Neither tiotropium RR p nor LABA by itself RR p was associated with mortality. Conclusions A combination of ICS and LABA reduced mortality by approximately 20 . Neither tiotropium nor LABA by itself modifies all-cause mortality in COPD. Introduction Chronic obstructive pulmonary disease COPD affects more than 300 million people worldwide 1 . It is currently the 4th leading cause of mortality accounting for nearly 3 million deaths annually and is the only