@misc{10481/102891,
year = {2025},
month = {2},
url = {https://hdl.handle.net/10481/102891},
abstract = {Introduction: COPD is a major public health concern, often complicated by cardiovascular comorbidities.
Single inhaler triple therapy (SITT) has been proposed as a superior treatment option compared to single
inhaler double therapies (SIDT) as LABA/LAMA and LABA/ICS. This systematic review and meta-analysis
aim to evaluate the comparative efficacy of these therapies in reducing cardiovascular mortality, major
adverse cardiovascular events (MACEs), and all-cause mortality (ACM).
Methods: We conducted a systematic review and metanalysis including RCT studies comparing SITT
with LABA/LAMA or LABA/ICS with mortality as efficacy or safety endpoints. Articles were selected
after reviewing PubMed, SCOPUS, Embase, Scielo and clinicaltrials.gov and clinicaltrialsregister.eu from
May’24 to Jul’24. Random-effects models were used to estimate the pooled odds ratios (HRs) and 95%
confidence intervals (CIs) for cardiovascular mortality, MACEs, and ACM. Heterogeneity and publication
bias were assessed using standard statistical methods.
Results: The systematic review yielded 568 studies of which 11 were finally included, with 25,774 COPD
patients. SITT was superior to LABA/LAMA on ACM (pooled HR 0.727; 95% CI 0.574–0.921, p = 0.008) and
cardiovascular mortality (pooled HR 0.455; 95% CI 0.292–0.710, p < 0.001), with no effect on MACEs. SITT
showed no difference versus LABA/ICS on ACM, cardiovascular mortality or MACEs.
Conclusions: SITT significantly reduces cardiovascular and all-cause mortality compared to LABA/LAMA.
Compared to LABA/ICS, SITT does not show a significant difference.},
publisher = {Elsevier},
title = {All-Cause and Cardiovascular Mortality With Single Inhaler Triple Therapy Versus Double Therapies for COPD: A Systematic Review and Metanalysis},
doi = {10.1016/j.arbres.2025.02.004},
author = {Hammadi, Ayoub and Hoyas-Sánchez, Clara and Romero Linares, Alejandro and Alvarez Muro, Lucía and Menéndez Lobo, Antonio and Romeral Navarro, Damaris and Jiménez Antón, Andrea and Almansa López, Ángel and Casares Martín Moreno, Laura and Sánchez Álvarez, Esther and Romero Palacios, Pedro José and Alcázar Navarrete, Bernardino},
}