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Summary

For FF/UMEC/VI, the NMA suggest favourable efficacy compared with other single-inhaler triple therapies.1

  • Reduced risk of moderate and severe exacerbations1:
    • Significantly greater reduction in annualised moderate/severe exacerbation rate, versus BUD/GLY/FOR (320/18/9.6; IRR: 0.62, P=0.0044) and BUD/GLY/FOR (160/18/9.6; IRR: 0.61, P=0.0034)
    • And a numerically greater reduction versus BDP/FOR/GLY (100/6/12.5; IRR: 0.73, NS, P=0.0774)
  • Improvement in trough FEV1:1
    • Significantly greater improvement in lung function at 12 weeks versus BUD/GLY/FOR (320/18/9.6; mean difference in CFB: 99.40 mL, P<0.0001) and BDP/FOR/GLY (100/6/12.5; mean difference in CFB: 46.70 mL, P=0.0037)
    • Significantly greater improvement in lung function at 24 weeks versus BUD/GLY/FOR (320/18/9.6; mean difference in CFB: 111.22 mL, P<0.0001) and BUD/GLY/FOR (160/18/9.6; mean difference in CFB: 110.77 mL, P<0.0001)

Considerations1

  • Differences in study design and patient populations of the included trials
  • Lack of common comparators in the network and differences in event definition between trials meant some comparisons were not possible (e.g. 52-week analyses, analyses of severe exacerbations and pneumonia)
  • Modelled estimates were used as input if available in the publications and estimated from raw data if not

Safety1

  • While AEs within each of the SITT studies were generally similar in incidence and type across treatment arms, no formal evaluation of safety through statistical analysis was undertaken owing to difficulties in different definition of events, particularly pneumonia, across trials. AEs from the trials included in the NMA are tabulated and available in the full publication1
  • There is no conclusive clinical evidence for intra-class differences in the magnitude of the pneumonia risk among ICS products2
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FF/UMEC/VI shows meaningful clinical benefits versus MITT and other SITTs for lung function and exacerbations and improvement in health status1

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Abbreviations

AE, adverse event; BDP, beclomethasone dipropionate; BUD, budesonide; CFB, change from baseline; FEV1, forced expiratory volume in 1 second; FF, fluticasone furoate; FOR, formoterol; GLY, glycopyrronium bromide; ICS, inhaled corticosteroid; IRR, incidence rate ratio; MITT, multiple-inhaler triple therapy; NMA, network meta-analysis; NS, not significant; SITT, single-inhaler triple therapy; SGRQ, St George’s Respiratory Questionnaire; TIO, tiotropium; UMEC, umeclidinium; VI, vilanterol.

References

  1. Ismaila AS, et al. Adv Ther. 2022;39:3957-3978.
  2. European Medicines Agency, Pharmacovigilance Risk Assessment Committee. Inhaled corticosteroids (ICS) containing medicinal products indicated in the treatment of chronic obstructive pulmonary disease (COPD). Available from https://www.ema.europa.eu/en/documents/referral/inhaled-corticosteroids-article-31-referral-prac-assessment-report_en.pdf. Accessed June 2022.

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NX-GBL-UCV-WCNT-220012 | Date of preparation: November 2022