The efficacy and safety of different long-acting β2-agonists combined with inhaled glucocorticoid regimens in patients with asthma: a network meta-analysis

J Asthma. 2019 Nov;56(11):1159-1171. doi: 10.1080/02770903.2018.1531991. Epub 2018 Oct 25.

Abstract

Objective: To determine the efficacy and safety of current maintenance therapies consisting of different regimens of long-acting β2-agonists (LABA) with inhaled corticosteroids (ICS) in patients with asthma. Methods: A network meta-analysis (NMA) was conducted after a comprehensive search for relevant studies in the PubMed, Cochrane Library, and Embase databases up to January 1, 2017. Randomized clinical trials comparing LABA combined with ICS in patients with asthma were selected. Results: Seventeen trials were included in the analysis, comprising 10,961 patients and seven treatment regimens. Our NMA revealed that there were no statistically significant differences between agents regarding the frequency of moderate or severe exacerbations. For adverse effects, there were no significant differences between the included studies. Moreover, six of the results showed no statistically significant differences between agents regarding symptom-free days. The heterogeneity and inconsistency analysis of the outcomes showed that there were no differences between the regimens. Conclusions: Our findings have shown that there were no statistically significant differences between the different regimens of LABA + ICS regarding the frequency of moderate or severe exacerbations, adverse events, and symptom-free days.

Keywords: Asthma; inhaled corticosteroids; long-acting β2-agonists; network meta-analysis.

MeSH terms

  • Administration, Inhalation
  • Adrenergic beta-2 Receptor Agonists / administration & dosage*
  • Adrenergic beta-2 Receptor Agonists / adverse effects
  • Anti-Asthmatic Agents / administration & dosage*
  • Anti-Asthmatic Agents / adverse effects
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / methods
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / adverse effects
  • Humans
  • Network Meta-Analysis
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Symptom Flare Up
  • Time Factors
  • Treatment Outcome

Substances

  • Adrenergic beta-2 Receptor Agonists
  • Anti-Asthmatic Agents
  • Glucocorticoids