Instituto de Biomedicina de Sevilla (IBiS), Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Avda. Manuel Siurot, s/n., Seville, 41013, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, Spain.
Ther Adv Respir Dis. 2019 Jan-Dec;13:1753466619885522. doi: 10.1177/1753466619885522.
We systematically reviewed the current knowledge on fixed-dose triple therapies for the treatment of chronic obstructive pulmonary disease (COPD), with a specific focus on its efficacy single bronchodilation, double fixed dose combinations, and open triple therapies. Articles were retrieved from PubMed, Embase, and Scopus up to 3 August 2018. We selected articles with randomized controlled or crossover design conducted in patients with COPD and published as full-length articles or scientific letters, evaluating triple therapy combinations in a single or different inhaler, and with efficacy data monocomponents, double combinations, or open triple therapies. Our systematic search reported 108 articles, of which 24 trials were finally selected for the analysis. A total of 7 studies with fixed dose triple therapy combinations, and 17 studies with open triple therapies combinations. Triple therapy showed improvements in lung function [trough forced expiratory volume (FEV ranging from not significant (NS) to 147 ml], health status using the St. George's Respiratory Questionnaire [(SGRQ) from NS to 8.8 points], and exacerbations [risk ratio (RR) from NS to 0.59 for all exacerbations] single or double therapies with a variability in the response, depending the specific combination, and the comparison group. The proportion of adverse effects was similar between study groups, the exception being the increase in pneumonia for some inhaled corticosteroid (ICS) containing groups.
我们系统地回顾了目前关于固定剂量三联疗法治疗慢性阻塞性肺疾病（COPD）的知识，特别关注其疗效，包括单一支气管扩张剂、双固定剂量联合用药和开放三联疗法。文章从 PubMed、Embase 和 Scopus 检索到 2018 年 8 月 3 日之前的文章。我们选择了随机对照或交叉设计的文章，这些文章在 COPD 患者中进行，作为全文文章或科学信件发表，评估了单一或不同吸入器中的三联疗法组合，以及与单组件、双组合或开放三联疗法的疗效数据。我们的系统搜索报告了 108 篇文章，其中 24 项试验最终被选中进行分析。共有 7 项固定剂量三联疗法组合的研究和 17 项开放三联疗法组合的研究。三联疗法在肺功能方面（FEV 1 用力呼气量）[从无显著改善（NS）到 147ml]、健康状况（圣乔治呼吸问卷[SGRQ]）[从 NS 到 8.8 分]和恶化方面（所有恶化的风险比[RR]）[从 NS 到 0.59]都有所改善，而单一或双重疗法的反应则有所不同，这取决于特定的组合和比较组。不良反应的比例在研究组之间相似，除了一些含有吸入性皮质类固醇（ICS）的组中肺炎的发生率增加。
