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Effectiveness of drug treatment strategies to prevent asthma exacerbations and increase symptom-free days in asthmatic children: a network meta-analysis
Zhao, Yile1; Han, Sheng2,3; Shang, Jinxin1; Zhao, Xizi1; Pu, Run4; Shi, Luwen1,3
关键词Asthma Children Exacerbation Network Meta-analysis Symptom-free Day
刊名JOURNAL OF ASTHMA
2015
DOI10.3109/02770903.2015.1014101
52期:8页:846-857
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Allergy ; Respiratory System
研究领域[WOS]Allergy ; Respiratory System
关键词[WOS]RANDOMIZED CONTROLLED-TRIAL ; BUDESONIDE INHALATION SUSPENSION ; MILD PERSISTENT ASTHMA ; CHILDHOOD ASTHMA ; DOUBLE-BLIND ; INHALED BUDESONIDE ; LUNG-FUNCTION ; FLUTICASONE PROPIONATE ; PEDIATRIC ASTHMA ; MONTELUKAST
英文摘要

Objective: To determine the effectiveness and safety of current maintenance therapies that include inhaled corticosteroids (ICS), long-acting beta-agonists (LABA) and/or leukotriene receptor antagonists (LTRAs) in preventing exacerbations and improving symptoms in pediatric asthma. Methods: A systematic review with network meta-analysis was conducted after a comprehensive search for relevant studies in the PubMed, Cochrane Library, Embase and Clinical Trials databases, up to July 2014. Randomized clinical trials were selected comparing treatment strategies of the Global Initiative for Asthma guidelines. The full-text randomized clinical trials compared maintenance treatments for asthma in children (<= 18 years) of >= 4 weeks duration, reporting exacerbations or symptom-free days. The primary and secondary effectiveness outcomes were the rates of moderate/severe exacerbations and symptom-free days from baseline, respectively. Withdrawal rates were taken as the safety outcome. Results: Included in the network meta-analysis was 35 trials, comprising 12 010 patients. For both primary and secondary outcomes, combined ICS and LABA was ranked first in effectiveness (OR 0.70, 95% CI: 0.52-0.97 and OR 1.23, 95% CI: 0.94-1.61, respectively, compared with low-dose ICS), but the result of secondary outcomes was statistically insignificant. Low-dose ICS, medium-or high-dose ICS and combined ICS and LTRA strategies were comparable in effectiveness. ICS monotherapies, and ICS + LABA and ICS + LTRA strategies were similarly safe. High-dose ICS had the highest rate of total withdrawals, but the difference was not significant. Conclusions: Combined ICS and LABA treatments were most effective in preventing exacerbations among pediatric asthma patients. Medium-or high-dose ICS, combined ICS and LTRAs, and low-dose ICS treatments seem to be equally effective.

语种英语
WOS记录号WOS:000361338200013
引用统计
被引频次:4[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/57240
专题北京大学药学院
作者单位1.Peking Univ, Sch Publ Hlth, Beijing 100191, Peoples R China
2.CNCBD, Beijing, Peoples R China
3.Peking Univ, Sch Pharmaceut Sci, Beijing 100191, Peoples R China
4.Peking Univ, Int Res Ctr Med Adm, Beijing 100191, Peoples R China
推荐引用方式
GB/T 7714
Zhao, Yile,Han, Sheng,Shang, Jinxin,et al. Effectiveness of drug treatment strategies to prevent asthma exacerbations and increase symptom-free days in asthmatic children: a network meta-analysis[J]. JOURNAL OF ASTHMA,2015,52(8):846-857.
APA Zhao, Yile,Han, Sheng,Shang, Jinxin,Zhao, Xizi,Pu, Run,&Shi, Luwen.(2015).Effectiveness of drug treatment strategies to prevent asthma exacerbations and increase symptom-free days in asthmatic children: a network meta-analysis.JOURNAL OF ASTHMA,52(8),846-857.
MLA Zhao, Yile,et al."Effectiveness of drug treatment strategies to prevent asthma exacerbations and increase symptom-free days in asthmatic children: a network meta-analysis".JOURNAL OF ASTHMA 52.8(2015):846-857.
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