Summary of findings 2. Aclidinium bromide compared to tiotropium for stable chronic obstructive pulmonary disease.
| Aclidinium bromide compared to tiotropium for stable chronic obstructive pulmonary disease | ||||||
| Patient or population: patients with stable chronic obstructive pulmonary disease Settings: community Intervention: aclidinium bromide Comparison: tiotropium | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Tiotropium | Aclidinium bromide | |||||
| Mortality (all‐cause) | See comment | See comment | Not estimable | 329 (1) | See comment | No deaths were reported |
| Exacerbations requiring steroids, antibiotics or both Follow‐up: 4‐6 weeks | 0 per 1000 | 11 per 1000 (0 to 26)1 | OR 2.64 (0.31 to 22.18) | 729 (2 studies) | ⊕⊝⊝⊝ very low2,3,4 | |
| Quality of life St George's Respiratory Questionnaire (SGRQ) score | See comment | See comment | Not estimable | 0 (0) | See comment | No studies measured and reported quality of life for aclidinium and tiotropium |
| Functional capacity Six‐minute walk distance | See comment | See comment | Not estimable | 0 (0) | See comment | No studies measured and reported functional capacity for aclidinium and tiotropium |
| Hospital admissions due to exacerbations Follow‐up: 4‐6 weeks | 4 per 1000 | 2 per 1000 (0 to 18) | OR 0.54 (0.07 to 4.11) | 729 (2 studies) | ⊕⊝⊝⊝ very low2,3,4 | |
| Non‐fatal serious adverse events Follow‐up: 4‐6 weeks | 18 per 1000 | 12 per 1000 (3 to 46) | OR 0.67 (0.17 to 2.65) | 729 (2 studies) | ⊕⊝⊝⊝ very low2,3,4 | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; OR: Odds ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 The corresponding risk for aclidinium bromide was calculated using the risk difference to avoid having zero in both columns.
2 ‐1 for high risk of bias in Chanez 2010 because it was open label for tiotropium arm. 3Chanez 2010 failed to report some outcomes of lung function in the published full text but it is unlikely to affect this outcome. 4 ‐2 for imprecision: the CI includes the possibility of both appreciable benefit or harm.