Mortality and drug therapy in patients with chronic obstructive pulmonary disease: a network meta-analysis

Scott, D. A., Woods, B., Thompson, J. C., Clark, J. F., Hawkins, N. , Chambers, M., Celli, B. R. and Calverley, P. (2015) Mortality and drug therapy in patients with chronic obstructive pulmonary disease: a network meta-analysis. BMC Pulmonary Medicine, 15(1), 145. (doi: 10.1186/s12890-015-0138-4) (PMID:26559138) (PMCID:PMC4642642)

[img]
Preview
Text
203643.pdf - Published Version
Available under License Creative Commons Attribution.

993kB

Abstract

Background: Increasing evidence suggests pharmacological treatments may impact on overall survival in Chronic Obstructive Pulmonary Disease (COPD) patients. Individual clinical trials are rarely powered to detect mortality differences between treatments and may not include all treatment options relevant to healthcare decision makers. Methods: A systematic review was conducted to identify RCTs of COPD treatments reporting mortality; evidence was synthesised using network meta-analysis (NMA). The analysis included 40 RCTs; a quantitative indirect comparison between 14 treatments using data from 55,220 patients was conducted. Results: The analysis reported two treatments reducing all-cause mortality; salmeterol/fluticasone propionate combination (SFC) was associated with a reduction in mortality versus placebo in the fixed effects (HR 0.79; 95 % Crl 0.67, 0.94) but not the random effects model (0.79; 0.56, 1.09). Indacaterol was associated with a reduction in mortality versus placebo in fixed (0.28; 0.08 to 0.85) and random effects (0.29; 0.08, 0.89) models. Mean estimates and credible intervals for hazard ratios for indacaterol versus placebo are based on a small number of events; estimates may change when the results of future studies are included. These results were maintained across a variety of assumptions and provide evidence that SFC and indacaterol may lead to improved survival in COPD patients. Conclusion: Results of an NMA of COPD treatments suggest that SFC and indacaterol may reduce mortality. Further research is warranted to strengthen this conclusion.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Hawkins, Professor Neil
Authors: Scott, D. A., Woods, B., Thompson, J. C., Clark, J. F., Hawkins, N., Chambers, M., Celli, B. R., and Calverley, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
Journal Name:BMC Pulmonary Medicine
Publisher:BMC
ISSN:1471-2466
ISSN (Online):1471-2466
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in BMC Pulmonary Medicine 15(1):145
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record