COMPARATIVE EFFECTIVENESS OF PHARMACOLOGICAL TREATMENTS FOR STABLE CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN THE CHINESE POPULATION: A BAYESIAN NETWORK META ANALYSIS
Author(s)
Chen Mu, BsC1, Nan Peng, PhD2, guoxian Lu, BsC1, Qi Li, BsC1, Dongning Yao, PhD1;
1Nanjing Medical University, Nanjing, China, 2School of Pharmaceutical Science and Technology,Tianjin University, Tianjin, China
1Nanjing Medical University, Nanjing, China, 2School of Pharmaceutical Science and Technology,Tianjin University, Tianjin, China
OBJECTIVES: A Bayesian network meta-analysis (NMA) was performed to compare the effects of different pharmacological treatment strategies on exacerbation risk, lung function, symptoms, health-related quality of life, and exercise capacity in Chinese patients with stable chronic obstructive pulmonary disease (COPD).
METHODS: A literature search was performed from January 2010 to December 2025. Randomized controlled trials evaluating the effectiveness of pharmacological treatments for stable COPD in the Chinese population were included. The risk of bias of included studies was assessed using the Cochrane Risk of Bias tool (RoB 2.0). Bayesian NMA were conducted to synthesize direct and indirect evidence across multiple clinical outcomes, including annualized exacerbation rate, forced expiratory volume in one second (FEV₁) at 12 and 24 weeks, St. George’s Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnea scale, and 6-minute walking distance (6MWD).
RESULTS: A total of 49 randomized controlled trials involving 11,929 participants were included in the NMA. The evidence network was well connected across most outcomes. Overall heterogeneity was low for all endpoints (I² generally <15%). Node-splitting analyses indicated good agreement between direct and indirect evidence for most treatment comparisons, with statistically significant inconsistency observed only in a limited number of comparisons for specific outcomes. Ranking analyses showed that triple inhaled therapy (LAMA/LABA/ICS) and traditional Chinese medicine (TCM) as add-on therapy consistently achieved higher surface under the cumulative ranking curve (SUCRA) values across multiple outcomes, including reduction in exacerbation risk, improvement in lung function, health-related quality of life, symptom burden, and exercise capacity.
CONCLUSIONS: Among the pharmacological treatments evaluated, LAMA/LABA/ICS was consistently associated with favorable outcomes across multiple clinical endpoints in patients with stable COPD in the Chinese population. TCM as add-on therapy also demonstrated beneficial effects in several outcomes. These findings highlight meaningful differences in treatment performance and may inform treatment selection in clinical practice.
METHODS: A literature search was performed from January 2010 to December 2025. Randomized controlled trials evaluating the effectiveness of pharmacological treatments for stable COPD in the Chinese population were included. The risk of bias of included studies was assessed using the Cochrane Risk of Bias tool (RoB 2.0). Bayesian NMA were conducted to synthesize direct and indirect evidence across multiple clinical outcomes, including annualized exacerbation rate, forced expiratory volume in one second (FEV₁) at 12 and 24 weeks, St. George’s Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnea scale, and 6-minute walking distance (6MWD).
RESULTS: A total of 49 randomized controlled trials involving 11,929 participants were included in the NMA. The evidence network was well connected across most outcomes. Overall heterogeneity was low for all endpoints (I² generally <15%). Node-splitting analyses indicated good agreement between direct and indirect evidence for most treatment comparisons, with statistically significant inconsistency observed only in a limited number of comparisons for specific outcomes. Ranking analyses showed that triple inhaled therapy (LAMA/LABA/ICS) and traditional Chinese medicine (TCM) as add-on therapy consistently achieved higher surface under the cumulative ranking curve (SUCRA) values across multiple outcomes, including reduction in exacerbation risk, improvement in lung function, health-related quality of life, symptom burden, and exercise capacity.
CONCLUSIONS: Among the pharmacological treatments evaluated, LAMA/LABA/ICS was consistently associated with favorable outcomes across multiple clinical endpoints in patients with stable COPD in the Chinese population. TCM as add-on therapy also demonstrated beneficial effects in several outcomes. These findings highlight meaningful differences in treatment performance and may inform treatment selection in clinical practice.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
SA19
Topic
Study Approaches
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)