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Umeclidinium Plus Vilanterol Versus Placebo, Umeclidinium, or Vilanterol Monotherapies for Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials

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Abstract

Background

The role of umeclidinium plus vilanterol as a combination therapy for chronic obstructive pulmonary disease (COPD) has not yet been clearly defined.

Objective

The aim of this meta-analysis was to evaluate the efficacy and safety of umeclidinium plus vilanterol, in contrast to either monotherapy or placebo.

Methods

Systematic searches were conducted in Pubmed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and the Chinese Biomedical Literature Database (CBM). Randomized clinical trials pertaining to the treatment of COPD with the combination of umeclidinium and vilanterol, versus umeclidinium, vilanterol or placebo, were reviewed. Studies were pooled to mean differences (MDs), with 95 % confidence intervals (CIs).

Results

Six studies were included in our meta-analysis. The application of umeclidinium plus vilanterol compared with umeclidinium alone showed increases in trough forced expiratory volume in 1 s [FEV1] (MD 0.05 L, 95 % CI 0.04–0.07; p < 0.00001) and forced vital capacity [FVC] (MD 0.07 L, 95 % CI 0.04–0.10; p < 0.00001). Similarly, versus vilanterol alone, the application of umeclidinium plus vilanterol showed increases in trough FEV1 (MD 0.10, 95 % CI 0.08–0.12; p < 0.00001) and FVC (MD 0.16 L, 95 % CI 0.13–0.20; p < 0.00001). Compared with placebo, umeclidinium plus vilanterol also showed increases in trough FEV1 (MD 0.21 L, 95 % CI 0.19–0.22; p < 0.00001) and FVC (MD 0.31 L, 95 % CI 0.26–0.35; p < 0.00001). In addition, umeclidinium plus vilanterol has beneficial effects on dyspnea, albuterol use, and health-related quality of life compared with the other three groups.

Conclusions

Compared with the other three groups, i.e. placebo, umeclidinium and vilanterol, umeclidinium plus vilanterol improves lung function and quality of life in patients with COPD, reduces the use of albuterol, and does not increase the incidence of adverse events and serious adverse events.

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Acknowledgments

The authors would like to acknowledge the librarians of Shandong Provincial Hospital Library for their contributions in the search strategies and full-text retrieval.

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Authors and Affiliations

  1. Department of Electrocardiogram, Shandong Provincial Hospital Affiliated to Shandong University, No. 324 Jing Wu Road, Jinan, 250021, Shandong, China

    Li Wang & Chun-juan Zhai

  2. Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, No. 324 Jing Wu Road, Jinan, 250021, Shandong, China

    Yao Liu, Yi Liu & Shu-juan Jiang

Authors
  1. Li Wang
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  2. Chun-juan Zhai
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  3. Yao Liu
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  4. Yi Liu
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Corresponding authors

Correspondence to Yi Liu or Shu-juan Jiang.

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Funding

No sources of funding were used to assist in the preparation of this study.

Conflict of interest

Li Wang, Chun-juan Zhai, Yao Liu, Yi Liu, Shu-juan Jiang declare that they have no conflicts of interest.

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Wang, L., Zhai, Cj., Liu, Y. et al. Umeclidinium Plus Vilanterol Versus Placebo, Umeclidinium, or Vilanterol Monotherapies for Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials. Clin Drug Investig 36, 865–875 (2016). https://doi.org/10.1007/s40261-016-0449-0

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