Evidence mapPaperPMID 38424530Full record

Observational studyBMC pulmonary medicine2024

Effects of triple therapy on disease burden in patients of GOLD groups C and D: results from the observational COPD cohort COSYCONET.

Jennifer A Zader, Rudolf A Jörres, Imke Mayer, Peter Alter, Robert Bals, Henrik Watz, Pontus Mertsch, Klaus F Rabe, Felix Herth, Franziska C Trudzinski and 6 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC pulmonary medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 8 institutions in 2 countries.

Jennifer A ZaderBerlin School of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany.
Rudolf A JörresInstitute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M), Ludwig-Maximilians-Universität München, Munich, Germany.
Imke MayerInstitute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany.
Peter AlterDepartment of Medicine, Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany, Marburg, Germany.
Robert BalsDepartment of Internal Medicine V - Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany.
Henrik WatzMember of the German Center for Lung Research, Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Woehrendamm 80, 22927, Grosshansdorf, Germany.
Pontus MertschDepartment of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany.
Klaus F RabeMember of the German Center for Lung Research, Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Woehrendamm 80, 22927, Grosshansdorf, Germany.
Felix HerthThoraxklinik-Heidelberg gGmbH, Röntgenstraße 1, 69126, Heidelberg, Germany.
Franziska C TrudzinskiThoraxklinik-Heidelberg gGmbH, Röntgenstraße 1, 69126, Heidelberg, Germany.
Tobias WelteDepartment of Pneumology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Hans-Ulrich KauczorDepartment of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Jürgen BehrDepartment of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany.
Julia WalterDepartment of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany.
Claus F VogelmeierDepartment of Medicine, Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany, Marburg, Germany.
Kathrin KahnertDepartment of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany. kathrin.kahnert@med.uni-muenchen.de.
German Center for Lung Research · DEBerlin Institute of Health at Charité - Universitätsmedizin Berlin · DEChristian-Albrechts-Universität zu Kiel · DEGerman Cancer Research Center · DEHelmholtz Institute for Pharmaceutical Research Saarland · DELudwig-Maximilians-Universität München · DEMedizinische Hochschule Hannover · DEPhysiologie et Médecine Expérimentale du Coeur et des Muscles · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRandomized controlled trials described beneficial effects of inhaled triple therapy (LABA/LAMA/ICS) in patients with chronic obstructive pulmonary disease (COPD) and high risk of exacerbations. We studied whether such effects were also detectable under continuous treatment in a retrospective observational setting.

methodsData from baseline and 18-month follow-up of the COPD cohort COSYCONET were used, including patients categorized as GOLD groups C/D at both visits (n = 258). Therapy groups were defined as triple therapy at both visits (triple always, TA) versus its complement (triple not always, TNA). Comparisons were performed via multiple regression analysis, propensity score matching and inverse probability weighting to adjust for differences between groups. For this purpose, variables were divided into predictors of therapy and outcomes.

resultsIn total, 258 patients were eligible (TA: n = 162, TNA: n = 96). Without adjustments, TA patients showed significant (p < 0.05) impairments regarding lung function, quality of life and symptom burden. After adjustments, most differences in outcomes were no more significant. Total direct health care costs were reduced but still elevated, with inpatient costs much reduced, while costs of total and respiratory medication only slightly changed.

conclusionWithout statistical adjustment, patients with triple therapy showed multiple impairments as well as elevated treatment costs. After adjusting for differences between treatment groups, differences were reduced. These findings are compatible with beneficial effects of triple therapy under continuous, long-term treatment, but also demonstrate the limitations encountered in the comparison of controlled intervention studies with observational studies in patients with severe COPD using different types of devices and compounds.

Indexed as

Pulmonary Disease, Chronic ObstructiveAdministration, InhalationAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsBronchodilator AgentsCost of IllnessDrug Therapy, CombinationHumansMuscarinic AntagonistsQuality of LifeRetrospective StudiesAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsBronchodilator AgentsMuscarinic AntagonistsCOPDHealth care costsLung functionSymptomsTriple therapy

Identifiers

PMID38424530
PMCPMC10905841
OpenAlexW4392352345

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.