Abstract: Objective  To evaluate the effectiveness and safety of umeclidinium/ inhaled corticosteroid/ longacting β2agonist (UMEC/ICS/LABA) in the treatment of chronic obstructive pulmonary disease(COPD).Methods  PubMed,  Embase,  Cochrane Central Register of Controlled Trials(CENTRAL),  ClinicalTrail.gov,  CBM,  VIP,  CNKI and WanFang Data were electronically searched for randomized controlled trials (RCTs) about UMEC/ICS/LABA for COPD from inception to May 28, 2018. Two reviewers independently screened literatures,  extracted data and assessed the risk of bias of included studies. Then,  metaanalysis was performed using RevMan 5.3 and R software. Results  Seven RCTs involving 13 219 patients were included. UMEC 62.5 μg/ICS/LABA vs PBO/ICS/LABA:UMEC 62.5 μg/ICS/LABA could significantly improve the lung function (trough FEV1［MD=0.13,  95%CI=0.10 to 0.15,  P＜0.00001］,  06 h  wmFEV1［MD=0.16,  95%CI  0.14 to 0.17,  P＜0.00001］,  Peak FEV1［MD=0.16,  95%CI 0.14 to 0.18,  P＜0.00001］,  Trough FVC ［MD=0.21,  95%CI 0.19 to 0.23, P＜0.00001］)  and the quality of life (SGRQ score［MD=-1.83,  95%CI -2.31 to 1.34,  P＜0.00001］,  TDI score［MD=0.54,  95%CI 0.29 to 0.78,  P＜0.00001］,  CAT score［MD=-0.93,  95%CI -1.29 to -0.57,  P＜0.00001］),  reduce the use of rescue drugs(salbutamol) and the rate of COPD acute exacerbation  (RR=0.84，95%CI［0.79，0.89］，P＜0.00001)  while not increase the drugrelating adverse events (RR=1.00，95%CI［0.90，1.12］，P=0.99］. ②UMEC 125 μg/ICS/LABA vs PBO/ICS/LABA : UMEC 125 μg/ICS/LABA could significantly improve the lung function and the quality of life,  reduce the use of rescue drugs(salbutamol).However there is no difference in the rate of COPD acute exacerbation ［RR=0.57，95%CI（0.24，1.37），P=0.21］  and a higher  drugrelating adverse events rate than the control group ［RR=1.44，95%CI（1.00，2.08），P=0.05］ .Conclusion  Both UMEC 62.5  μg and 125  μg  in combination with ICS/LABA are superior to PBO/ICS/LABA in the treatment of COPD patients,  which can significantly improve lung function and the quality of life. UMEC 62.5  μg is preferred because of the lower adverse events rate. However,  due to the limitation of quantity of included studies,  this conclusion should be further confirmed by more high quality studies. 

Key words: pulmonary disease, , chronic obstructive；umeclidinium； triple；systematic review；metaanalysis