Table 3 Effect of ICS based therapies on the risk of COPD exacerbation
From: Pharmacological strategies to reduce exacerbation risk in COPD: a narrative review
Treatment [Reference] | Annual exacerbation rate | Comparator | Annual exacerbation rate | Reduction in exacerbations | Exacerbation endpoint | Patient population | |
|---|---|---|---|---|---|---|---|
Exacerbation entry criteria (No./year) | FEV1 % predicted | ||||||
ICS | |||||||
 FP [131] | 0.93 | Placebo | 0.73 | NS | Primary | NA | <90 % (post-BD) |
 FP [13] | 0.93 | Placebo | 1.13 | 18 % | Secondary (moderate or severe) | NA | <60 % (pre-BD) |
 FP [65] | 1.05 | Placebo | 1.30 | 19 % | Secondary (any) | ≥1 | 25–70 % (pre-BD) |
 FP [132] | 0.99 | Placebo | 1.32 | 25 % | Secondary (any) | NA | <85 % (post-BD) |
LABA/ICS | |||||||
 SFC [133] | 0.44 | Salmeterol | 0.48 | NS | Primary (severe) | ≥1 (last 14 days) | <70 % (pre-BD) |
 SFC [134] | 1.10 | Salmeterol | 1.59 | 30.4 % | Primary (moderate or severe) | ≥1 | <50 % |
 SFC [13] | 0.85 | Placebo Salmeterol FP | 1.13 0.97 0.93 | 25 % 12 % 9 % | Secondary (moderate or severe) | NA | <60 % (pre-BD) |
 SFC [65] | 0.97 | Placebo | 1.30 | 25 % | Secondary (moderate) | ≥1 | 25–70 % (pre-BD) |
 SFC [135] | 1.06 | Salmeterol | 1.53 | 30.5 % | Primary | ≥1 | <50 % |
1.28 | Tiotropium | 1.32 | NS | Primary (moderate or severe) | NA | <50Â % (post-BD) | |
 SFC [137] | 0.92 | Salmeterol | 1.4 | 35 % | Primary (moderate or severe) | ≥2 | <50 % (post-BD) |
 Bud/Form [80] | 1.38 | Placebo Formeterol Budesonide | 1.80 1.85 1.60 | 23.6 % NS NS | Primary (all) | ≥1 | <50 % (pre-BD) |
 Bud/Form [81] | 1.42 | Placebo Formoterol Budesonide | 1.87 1.84 1.59 | 24 % 23 % NS | Primary (severe) | ≥1 | <50 % |
 Bud/Form [138] | 0.70 (320/9 μg) 0.79 (160/9 μg) | Formoterol | 1.07 | 34.6 % 25.9 % | Primary (moderate or severe) | ≥1 | ≤50 % (pre-BD) |
 Bud/Form [139] | NR | Formoterol | NR | 36 % | Secondary (any) | ≥1 | ≤50 % (pre-BD) |
 FF/VI [79] | 0.81 | Vilanterol | 1.11 | 30 %(Pooled data) | Primary (moderate or severe) | ≥1 | <70 % (post-BD) |
 BDP/FOR [140] | 0.80 | Formoterol | 1.12 | 28 % | Primary (moderate or severe) | ≥1 | <50 % |
 BDP/FOR [141] | 0.41 | Bud/Form Formoterol | 0.42 0.43 | NS | Primary | ≥1 | 30–50 % (post-BD) |
Triple therapy | |||||||
 Tiotropium + salmeterol + FP [64] | 1.37 | Tiotropium | 1.61 | NS | Secondary (any) | ≥1 | <65 % (post-BD) |