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Review: long-acting inhaled therapies and pulmonary rehabilitation are effective in stable COPD

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T J Wilt

Dr T J Wilt, Veterans Affairs Medical Center, Minneapolis, MN, USA; tim.wilt@med.va.gov

REVIEW PROCESS

Question:

in patients with stable chronic obstructive pulmonary disease (COPD), are inhaled therapies and other interventions effective?

Search methods:

Medline and Cochrane Library (1966 to March 2007), Cochrane Database of Systematic Reviews of Effectiveness, reference lists, and experts.

Study selection and assessment:

English-language randomised controlled trials (RCTs), controlled clinical trials, or reviews evaluating inhaled therapies (β-agonists, corticosteroids [CSs], anticholinergics, or combination), pulmonary rehabilitation (PR), disease management, or oxygen therapy (OT) in patients with stable COPD. Studies reporting only spirometry outcomes or comparing different PRs were excluded. Assessment of individual study quality was based on blinding, allocation concealment, follow-up, intention-to-treat analysis, and funding; review quality was based on the Strength of Recommendation Taxonomy. 42 RCTs (mean age range 48–77 y) and 8 meta-analyses met the selection criteria.

Outcomes:

included exacerbations, death, and changes in St George’s Respiratory Questionnaire (SGRQ) or Chronic Respiratory Disease …

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