Meta-analysis: Anticholinergics, but not β-agonists, reduce severe exacerbations and respiratory mortality in COPD View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2006-10

AUTHORS

Shelley R. Salpeter, Nicholas S. Buckley, Edwin E. Salpeter

ABSTRACT

BACKGROUND: Anticholinergics and β2-agonists have generally been considered equivalent choices for bronchodilation in chronic obstructive pulmonary disease (COPD).OBJECTIVE: To assess the safety and efficacy of anticholinergics and β2-agonists in COPD.DESIGN: We comprehensively searched electronic databases from 1966 to December 2005, clinical trial websites, and references from selected reviews. We included randomized controlled trials of at least 3 months duration that evaluated anticholinergic or β2-agonist use compared with placebo or each other in patients with COPD.MEASUREMENTS: We evaluated the relative risk (RR) of exacerbations requiring withdrawal from the trial, severe exacerbations requiring hospitalization, and deaths attributed to a lower respiratory event.RESULTS: Pooled results from 22 trials with 15,276 participants found that anticholinergic use significantly reduced severe exacerbations (RR 0.67, confidence interval [CI] 0.53 to 0.86) and respiratory deaths (RR 0.27, CI 0.09 to 0.81) compared with placebo. β2-Agonist use did not affect severe exacerbations (RR 1.08, CI 0.61 to 1.95) but resulted in a significantly increased rate of respiratory deaths (RR 2.47, CI 1.12 to 5.45) compared with placebo. There was a 2-fold increased risk for severe exacerbations associated with β2-agonists compared with anticholinergics (RR 1.95, CI 1.39 to 2.93). The addition of β2-agonist to anticholinergic use did not improve any clinical outcomes.CONCLUSION: Inhaled anticholinergics significantly reduced severe exacerbations and respiratory deaths in patients with COPD, while β2-agonists were associated with an increased risk for respiratory deaths. This suggests that anticholinergics should be the bronchodilator of choice in patients with COPD, and β2-agonists may be associated with worsening of disease control. More... »

PAGES

1011-1019

Identifiers

URI

http://scigraph.springernature.com/pub.10.1111/j.1525-1497.2006.00507.x

DOI

http://dx.doi.org/10.1111/j.1525-1497.2006.00507.x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1030196607

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/16970553


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1102", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Cardiorespiratory Medicine and Haematology", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Adrenergic beta-Agonists", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Cholinergic Antagonists", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Humans", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Pulmonary Disease, Chronic Obstructive", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Randomized Controlled Trials as Topic", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "alternateName": "Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA, USA", 
          "id": "http://www.grid.ac/institutes/grid.415182.b", 
          "name": [
            "Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA", 
            "Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Salpeter", 
        "givenName": "Shelley R.", 
        "id": "sg:person.012160071167.38", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.012160071167.38"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "International Baccalaureate Program, Sequoia High School, Redwood City, CA, USA", 
          "id": "http://www.grid.ac/institutes/None", 
          "name": [
            "International Baccalaureate Program, Sequoia High School, Redwood City, CA, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Buckley", 
        "givenName": "Nicholas S.", 
        "id": "sg:person.01076436625.24", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01076436625.24"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Center for Radiophysics and Space Research, Cornell University, Ithaca, NY, USA", 
          "id": "http://www.grid.ac/institutes/grid.5386.8", 
          "name": [
            "Center for Radiophysics and Space Research, Cornell University, Ithaca, NY, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Salpeter", 
        "givenName": "Edwin E.", 
        "id": "sg:person.0744674145.06", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0744674145.06"
        ], 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "sg:pub.10.2165/00002512-200421060-00005", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1044511580", 
          "https://doi.org/10.2165/00002512-200421060-00005"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1471-2466-5-3", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1009077314", 
          "https://doi.org/10.1186/1471-2466-5-3"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.2165/00003495-198020040-00001", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1001300936", 
          "https://doi.org/10.2165/00003495-198020040-00001"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.2165/00002018-199207010-00007", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1053525213", 
          "https://doi.org/10.2165/00002018-199207010-00007"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.2165/00002018-200427100-00001", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1048743769", 
          "https://doi.org/10.2165/00002018-200427100-00001"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2006-10", 
    "datePublishedReg": "2006-10-01", 
    "description": "BACKGROUND: Anticholinergics and \u03b22-agonists have generally been considered equivalent choices for bronchodilation in chronic obstructive pulmonary disease (COPD).OBJECTIVE: To assess the safety and efficacy of anticholinergics and \u03b22-agonists in COPD.DESIGN: We comprehensively searched electronic databases from 1966 to December 2005, clinical trial websites, and references from selected reviews. We included randomized controlled trials of at least 3 months duration that evaluated anticholinergic or \u03b22-agonist use compared with placebo or each other in patients with COPD.MEASUREMENTS: We evaluated the relative risk (RR) of exacerbations requiring withdrawal from the trial, severe exacerbations requiring hospitalization, and deaths attributed to a lower respiratory event.RESULTS: Pooled results from 22 trials with 15,276 participants found that anticholinergic use significantly reduced severe exacerbations (RR 0.67, confidence interval [CI] 0.53 to 0.86) and respiratory deaths (RR 0.27, CI 0.09 to 0.81) compared with placebo. \u03b22-Agonist use did not affect severe exacerbations (RR 1.08, CI 0.61 to 1.95) but resulted in a significantly increased rate of respiratory deaths (RR 2.47, CI 1.12 to 5.45) compared with placebo. There was a 2-fold increased risk for severe exacerbations associated with \u03b22-agonists compared with anticholinergics (RR 1.95, CI 1.39 to 2.93). The addition of \u03b22-agonist to anticholinergic use did not improve any clinical outcomes.CONCLUSION: Inhaled anticholinergics significantly reduced severe exacerbations and respiratory deaths in patients with COPD, while \u03b22-agonists were associated with an increased risk for respiratory deaths. This suggests that anticholinergics should be the bronchodilator of choice in patients with COPD, and \u03b22-agonists may be associated with worsening of disease control.", 
    "genre": "article", 
    "id": "sg:pub.10.1111/j.1525-1497.2006.00507.x", 
    "isAccessibleForFree": true, 
    "isPartOf": [
      {
        "id": "sg:journal.1096256", 
        "issn": [
          "0884-8734", 
          "1525-1497"
        ], 
        "name": "Journal of General Internal Medicine", 
        "publisher": "Springer Nature", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "10", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "21"
      }
    ], 
    "keywords": [
      "chronic obstructive pulmonary disease", 
      "\u03b22-agonist use", 
      "severe exacerbations", 
      "respiratory deaths", 
      "relative risk", 
      "\u03b22 agonists", 
      "efficacy of anticholinergics", 
      "bronchodilator of choice", 
      "obstructive pulmonary disease", 
      "clinical trials website", 
      "anticholinergic use", 
      "pulmonary disease", 
      "clinical outcomes", 
      "Trials website", 
      "respiratory events", 
      "months duration", 
      "anticholinergics", 
      "respiratory mortality", 
      "exacerbation", 
      "electronic databases", 
      "placebo", 
      "disease control", 
      "patients", 
      "\u03b2-agonists", 
      "death", 
      "trials", 
      "risk", 
      "bronchodilation", 
      "bronchodilators", 
      "hospitalization", 
      "mortality", 
      "disease", 
      "efficacy", 
      "outcomes", 
      "withdrawal", 
      "duration", 
      "safety", 
      "use", 
      "participants", 
      "review", 
      "database", 
      "control", 
      "rate", 
      "events", 
      "choice", 
      "equivalent choices", 
      "addition", 
      "results", 
      "websites", 
      "reference"
    ], 
    "name": "Meta-analysis: Anticholinergics, but not \u03b2-agonists, reduce severe exacerbations and respiratory mortality in COPD", 
    "pagination": "1011-1019", 
    "productId": [
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1030196607"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1111/j.1525-1497.2006.00507.x"
        ]
      }, 
      {
        "name": "pubmed_id", 
        "type": "PropertyValue", 
        "value": [
          "16970553"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1111/j.1525-1497.2006.00507.x", 
      "https://app.dimensions.ai/details/publication/pub.1030196607"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2022-09-02T15:52", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-springernature-scigraph/baseset/20220902/entities/gbq_results/article/article_430.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "https://doi.org/10.1111/j.1525-1497.2006.00507.x"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1111/j.1525-1497.2006.00507.x'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1111/j.1525-1497.2006.00507.x'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1111/j.1525-1497.2006.00507.x'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1111/j.1525-1497.2006.00507.x'


 

This table displays all metadata directly associated to this object as RDF triples.

172 TRIPLES      21 PREDICATES      86 URIs      73 LITERALS      12 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1111/j.1525-1497.2006.00507.x schema:about N0ef9997d33cd45af83ccd9bd89ff9080
2 N3ca2b20854964d348cccb12883e9d0c4
3 N5258591213ff48d491c208b26d60d629
4 Na3f5c62de04542d09e7d310733e1cb9d
5 Nafb52989d9464ed18421d40017caeaef
6 anzsrc-for:11
7 anzsrc-for:1102
8 schema:author N96def319b0b54d7aa690435b01327fac
9 schema:citation sg:pub.10.1186/1471-2466-5-3
10 sg:pub.10.2165/00002018-199207010-00007
11 sg:pub.10.2165/00002018-200427100-00001
12 sg:pub.10.2165/00002512-200421060-00005
13 sg:pub.10.2165/00003495-198020040-00001
14 schema:datePublished 2006-10
15 schema:datePublishedReg 2006-10-01
16 schema:description BACKGROUND: Anticholinergics and β2-agonists have generally been considered equivalent choices for bronchodilation in chronic obstructive pulmonary disease (COPD).OBJECTIVE: To assess the safety and efficacy of anticholinergics and β2-agonists in COPD.DESIGN: We comprehensively searched electronic databases from 1966 to December 2005, clinical trial websites, and references from selected reviews. We included randomized controlled trials of at least 3 months duration that evaluated anticholinergic or β2-agonist use compared with placebo or each other in patients with COPD.MEASUREMENTS: We evaluated the relative risk (RR) of exacerbations requiring withdrawal from the trial, severe exacerbations requiring hospitalization, and deaths attributed to a lower respiratory event.RESULTS: Pooled results from 22 trials with 15,276 participants found that anticholinergic use significantly reduced severe exacerbations (RR 0.67, confidence interval [CI] 0.53 to 0.86) and respiratory deaths (RR 0.27, CI 0.09 to 0.81) compared with placebo. β2-Agonist use did not affect severe exacerbations (RR 1.08, CI 0.61 to 1.95) but resulted in a significantly increased rate of respiratory deaths (RR 2.47, CI 1.12 to 5.45) compared with placebo. There was a 2-fold increased risk for severe exacerbations associated with β2-agonists compared with anticholinergics (RR 1.95, CI 1.39 to 2.93). The addition of β2-agonist to anticholinergic use did not improve any clinical outcomes.CONCLUSION: Inhaled anticholinergics significantly reduced severe exacerbations and respiratory deaths in patients with COPD, while β2-agonists were associated with an increased risk for respiratory deaths. This suggests that anticholinergics should be the bronchodilator of choice in patients with COPD, and β2-agonists may be associated with worsening of disease control.
17 schema:genre article
18 schema:isAccessibleForFree true
19 schema:isPartOf N113e6cdedc6e4971b615d9bcb320b2b7
20 Nbe9f0f9ffa834581a81f943f5996e6e4
21 sg:journal.1096256
22 schema:keywords Trials website
23 addition
24 anticholinergic use
25 anticholinergics
26 bronchodilation
27 bronchodilator of choice
28 bronchodilators
29 choice
30 chronic obstructive pulmonary disease
31 clinical outcomes
32 clinical trials website
33 control
34 database
35 death
36 disease
37 disease control
38 duration
39 efficacy
40 efficacy of anticholinergics
41 electronic databases
42 equivalent choices
43 events
44 exacerbation
45 hospitalization
46 months duration
47 mortality
48 obstructive pulmonary disease
49 outcomes
50 participants
51 patients
52 placebo
53 pulmonary disease
54 rate
55 reference
56 relative risk
57 respiratory deaths
58 respiratory events
59 respiratory mortality
60 results
61 review
62 risk
63 safety
64 severe exacerbations
65 trials
66 use
67 websites
68 withdrawal
69 β-agonists
70 β2 agonists
71 β2-agonist use
72 schema:name Meta-analysis: Anticholinergics, but not β-agonists, reduce severe exacerbations and respiratory mortality in COPD
73 schema:pagination 1011-1019
74 schema:productId N0edffb3226194efdb9ad6301003c72dd
75 N62827f7b8d1f479c92a704db20a06424
76 Nf283d5e0a08d4382987b17148434d86c
77 schema:sameAs https://app.dimensions.ai/details/publication/pub.1030196607
78 https://doi.org/10.1111/j.1525-1497.2006.00507.x
79 schema:sdDatePublished 2022-09-02T15:52
80 schema:sdLicense https://scigraph.springernature.com/explorer/license/
81 schema:sdPublisher N89a855cd9a13430f92eeb0b0c6f6701d
82 schema:url https://doi.org/10.1111/j.1525-1497.2006.00507.x
83 sgo:license sg:explorer/license/
84 sgo:sdDataset articles
85 rdf:type schema:ScholarlyArticle
86 N0edffb3226194efdb9ad6301003c72dd schema:name doi
87 schema:value 10.1111/j.1525-1497.2006.00507.x
88 rdf:type schema:PropertyValue
89 N0ef9997d33cd45af83ccd9bd89ff9080 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
90 schema:name Randomized Controlled Trials as Topic
91 rdf:type schema:DefinedTerm
92 N113e6cdedc6e4971b615d9bcb320b2b7 schema:issueNumber 10
93 rdf:type schema:PublicationIssue
94 N3b2a72df1f344110b37583d6715302e2 rdf:first sg:person.0744674145.06
95 rdf:rest rdf:nil
96 N3ca2b20854964d348cccb12883e9d0c4 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
97 schema:name Pulmonary Disease, Chronic Obstructive
98 rdf:type schema:DefinedTerm
99 N44ce3986756c4b8594074da327bcd1b2 rdf:first sg:person.01076436625.24
100 rdf:rest N3b2a72df1f344110b37583d6715302e2
101 N5258591213ff48d491c208b26d60d629 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
102 schema:name Humans
103 rdf:type schema:DefinedTerm
104 N62827f7b8d1f479c92a704db20a06424 schema:name pubmed_id
105 schema:value 16970553
106 rdf:type schema:PropertyValue
107 N89a855cd9a13430f92eeb0b0c6f6701d schema:name Springer Nature - SN SciGraph project
108 rdf:type schema:Organization
109 N96def319b0b54d7aa690435b01327fac rdf:first sg:person.012160071167.38
110 rdf:rest N44ce3986756c4b8594074da327bcd1b2
111 Na3f5c62de04542d09e7d310733e1cb9d schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
112 schema:name Cholinergic Antagonists
113 rdf:type schema:DefinedTerm
114 Nafb52989d9464ed18421d40017caeaef schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
115 schema:name Adrenergic beta-Agonists
116 rdf:type schema:DefinedTerm
117 Nbe9f0f9ffa834581a81f943f5996e6e4 schema:volumeNumber 21
118 rdf:type schema:PublicationVolume
119 Nf283d5e0a08d4382987b17148434d86c schema:name dimensions_id
120 schema:value pub.1030196607
121 rdf:type schema:PropertyValue
122 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
123 schema:name Medical and Health Sciences
124 rdf:type schema:DefinedTerm
125 anzsrc-for:1102 schema:inDefinedTermSet anzsrc-for:
126 schema:name Cardiorespiratory Medicine and Haematology
127 rdf:type schema:DefinedTerm
128 sg:journal.1096256 schema:issn 0884-8734
129 1525-1497
130 schema:name Journal of General Internal Medicine
131 schema:publisher Springer Nature
132 rdf:type schema:Periodical
133 sg:person.01076436625.24 schema:affiliation grid-institutes:None
134 schema:familyName Buckley
135 schema:givenName Nicholas S.
136 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01076436625.24
137 rdf:type schema:Person
138 sg:person.012160071167.38 schema:affiliation grid-institutes:grid.415182.b
139 schema:familyName Salpeter
140 schema:givenName Shelley R.
141 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.012160071167.38
142 rdf:type schema:Person
143 sg:person.0744674145.06 schema:affiliation grid-institutes:grid.5386.8
144 schema:familyName Salpeter
145 schema:givenName Edwin E.
146 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0744674145.06
147 rdf:type schema:Person
148 sg:pub.10.1186/1471-2466-5-3 schema:sameAs https://app.dimensions.ai/details/publication/pub.1009077314
149 https://doi.org/10.1186/1471-2466-5-3
150 rdf:type schema:CreativeWork
151 sg:pub.10.2165/00002018-199207010-00007 schema:sameAs https://app.dimensions.ai/details/publication/pub.1053525213
152 https://doi.org/10.2165/00002018-199207010-00007
153 rdf:type schema:CreativeWork
154 sg:pub.10.2165/00002018-200427100-00001 schema:sameAs https://app.dimensions.ai/details/publication/pub.1048743769
155 https://doi.org/10.2165/00002018-200427100-00001
156 rdf:type schema:CreativeWork
157 sg:pub.10.2165/00002512-200421060-00005 schema:sameAs https://app.dimensions.ai/details/publication/pub.1044511580
158 https://doi.org/10.2165/00002512-200421060-00005
159 rdf:type schema:CreativeWork
160 sg:pub.10.2165/00003495-198020040-00001 schema:sameAs https://app.dimensions.ai/details/publication/pub.1001300936
161 https://doi.org/10.2165/00003495-198020040-00001
162 rdf:type schema:CreativeWork
163 grid-institutes:None schema:alternateName International Baccalaureate Program, Sequoia High School, Redwood City, CA, USA
164 schema:name International Baccalaureate Program, Sequoia High School, Redwood City, CA, USA
165 rdf:type schema:Organization
166 grid-institutes:grid.415182.b schema:alternateName Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA, USA
167 schema:name Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA, USA
168 Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
169 rdf:type schema:Organization
170 grid-institutes:grid.5386.8 schema:alternateName Center for Radiophysics and Space Research, Cornell University, Ithaca, NY, USA
171 schema:name Center for Radiophysics and Space Research, Cornell University, Ithaca, NY, USA
172 rdf:type schema:Organization
 




Preview window. Press ESC to close (or click here)


...