Glycopyrronium significantly improves lung function, dyspnea and health status in COPD patients in all GOLD groups
Bibliographic record
Abstract
Glycopyrronium (GLY) and tiotropium (TIO) are inhaled LAMAs recommended for COPD patients in all GOLD groups (A,B,C&D).1 GLY is effective and well tolerated in moderate-to-severe COPD patients, similar to TIO, and has faster onset and better bronchodilation in the first 4h after first dose. GLY and TIO efficacy was analyzed post hoc in patients by GOLD group (A,B,C&D), with data from 4 randomized controlled clinical trials, pooled and adjusted by mix-model. Patient classification (A&C, fewer symptoms; B&D, more symptoms) was based on baseline dyspnea index (BDI; ≥7/<7)2 and lung function (FEV1; </> 50% predicted normal) not considering baseline exacerbation risk. Efficacy of GLY and TIO was measured by mean change from baseline at 12 weeks for trough FEV1(tFEV1), health status (SGRQ score) and dyspnea (TDI score). Out of 2599 patients (GLY=1628; TIO=971),30.6% and 26.7% were in the low-symptom groups A&C, with baseline mean(SD) BDI scores of 5.11(1.31) & 4.72(1.47) respectively, and baseline FEV1 % predicted normal mean(SD) 62.54(7.94) & 40.50(6.07); 29.7% and 13.1% patients were in the high-symptom groups B&D, respectively, with BDI=8.18(1.29) & 7.95(1.23) and baseline FEV1% predicted normal=64.66(8.58) & 41.85(5.68), respectively. Based on the least square means change from baseline at 12 weeks, GLY led to statistically significant and clinically relevant improvements in tFEV1, dyspnea and health status in all GOLD groups; there was no significant difference between GLY and TIO. In conclusion, GLY improved lung function, dyspnea and health status in COPD patients in all GOLD groups, similar to TIO. GOLD 2015 Ozalevli et al 2006 J Eval Clin Pract 12; 532–538.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".