Effectiveness of different treatments in Chronic obstructive pulmonary disease patients: an individual patient data pooled analysis of RCTs

Effectiveness of different treatments in Chronic obstructive pulmonary disease patients: an individual patient data pooled analysis of RCTs

Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic symptoms (dyspnea, cough, sputum production) due to abnormalities of the airways and/alveoli that cause persistent airflow obstruction. The latest medical guideline recommends the therapy strategy (choice of single [Long-Acting Muscarinic Anatgonist, LAMA] or dual therapy [Long-Acting Beta Agonist (LABA)/LAMA]) of COPD based on the individual symptoms and exacerbation history.[1] However, there is no high-quality evidence to support this strategy. In the recent year, an trial suggested the therapy could benefit patients with mild to moderate COPD (forced expiratory valume in 1 second [FEV1] > 50% of predicted value).[2] However, whether choice of single or dual therapy based on lung function level (FEV1 of predicted value) is the well remains unknown. Therefore, the optimal strategy for COPD daily therapy reminds unclear.We aim to compare the effectiveness of single or dual therapy in COPD patients with different lung function levels, symptom scores, and acute exacerbation histories. With this pooled analysis, we could provide an evidence based strategy for the selection of medications for COPD daily therapy.Using a single indicator to assess the benefit of therapy is not reasonable.[3] Therefore, this study will choose the clinically important deterioration (CID, a composite outcome determined by lung function, symptom or health status score, and exacerbations) as the primary outcome to evaluate the effectiveness of therapies.Reference:1.   Global Initiative for Chronic Obstructive Lung Disease (GOLD). GLOBAL STRATEGY FOR PREVENTION, DIAGNOSIS AND MANAGEMENT OF COPD: 2023 Reprot. https://goldcopd.org/2023-gold-reports/. Update 2023.2.   Zhou Y, Zhong NS, Li X, et al. Tiotropium in Early-Stage Chronic Obstructive Pulmonary Disease. N Engl J Med. 2017;377(10):923-935. 3.   Singh, D., Criner, G. J., Naya, I., et al. Measuring disease activity in COPD: is clinically important deterioration the answer?. Respiratory research, 21(1), 134.

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