International journal of chronic obstructive pulmonary disease
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Int J Chron Obstruct Pulmon Dis · Jan 2015
Review Meta AnalysisComparative efficacy of long-acting muscarinic antagonist monotherapies in COPD: a systematic review and network meta-analysis.
Randomized, controlled trials comparing long-acting muscarinic antagonist (LAMA) efficacy in COPD are limited. This network meta-analysis (NMA) assessed the relative efficacy of tiotropium 18 µg once-daily (OD) and newer agents (aclidinium 400 µg twice-daily, glycopyrronium 50 µg OD, and umeclidinium 62.5 µg OD). ⋯ The new LAMAs studied had at least comparable efficacy to tiotropium, the established class standard. Choice should depend on physician's and patient's preference.
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Int J Chron Obstruct Pulmon Dis · Jan 2015
Review Meta AnalysisSupported self-management for patients with COPD who have recently been discharged from hospital: a systematic review and meta-analysis.
Although many hospitals promote self-management to chronic obstructive pulmonary disease (COPD) patients post discharge from hospital, the clinical effectiveness of this is unknown. We undertook a systematic review of the evidence as part of a Health Technology Assessment review. ⋯ There is insufficient evidence to support self-management interventions post-discharge. There is a need for good quality primary research to identify effective approaches.
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Int J Chron Obstruct Pulmon Dis · Jan 2015
Review Meta AnalysisEffectiveness of bronchoscopic lung volume reduction using unilateral endobronchial valve: a systematic review and meta-analysis.
Bronchoscopic lung volume reduction (BLVR) can be suggested as an alternative for surgical lung volume reduction surgery for severe emphysema patients. This article intends to evaluate by systematic review the safety and effectiveness of BLVR using a one-way endobronchial valve. ⋯ BLVR may be an effective and safe procedure for the treatment of severe COPD patients with emphysema, based on existing studies.
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Int J Chron Obstruct Pulmon Dis · Jan 2015
Review Meta AnalysisEffectiveness of pulmonary rehabilitation in COPD with mild symptoms: a systematic review with meta-analyses.
Most guidelines recommend pulmonary rehabilitation (PR) for patients with chronic obstructive pulmonary disease (COPD) and modified Medical Research Council dyspnea scale (mMRC) levels ≥2, but the effectiveness of PR in patients with less advanced disease is not well established. Our aim was to investigate the effects of PR in patients with COPD and mMRC ≤1. ⋯ We found a moderate quality of evidence suggesting a small, significant improvement in short-term HRQoL and a clinically nonsignificant improvement in walking distance following PR in patients with COPD and mild symptoms. This resulted in a weak recommendation of routine PR in these patients using the GRADE approach.
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Int J Chron Obstruct Pulmon Dis · Jan 2015
Review Meta AnalysisEffectiveness of pulmonary rehabilitation in COPD with mild symptoms: a systematic review with meta-analyses.
Most guidelines recommend pulmonary rehabilitation (PR) for patients with chronic obstructive pulmonary disease (COPD) and modified Medical Research Council dyspnea scale (mMRC) levels ≥2, but the effectiveness of PR in patients with less advanced disease is not well established. Our aim was to investigate the effects of PR in patients with COPD and mMRC ≤1. ⋯ We found a moderate quality of evidence suggesting a small, significant improvement in short-term HRQoL and a clinically nonsignificant improvement in walking distance following PR in patients with COPD and mild symptoms. This resulted in a weak recommendation of routine PR in these patients using the GRADE approach.