Chen Xiaoju, Xiong Liang, Qin Shouming, Ma Wanli, Zhou Qiong
Department of Respiratory Diseases, Union Hospital, Key Lab of Pulmonary Diseases of Health Ministry, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 530021, China.
J Huazhong Univ Sci Technolog Med Sci. 2011 Feb;31(1):137-141. doi: 10.1007/s11596-011-0165-1. Epub 2011 Feb 19.
It remains controversial whether tumor necrosis factor (TNF)-α antagonism is effective for asthma. This meta-analysis was performed to evaluate efficacy of TNF-α antagonism in treatment of patients with asthma. MEDLINE, EMBASE, LILACS, and CINAHL databases were searched for English-language studies published through January 3, 2010. Randomized-controlled trials comparing TNF-α antagonism with control therapy were selected. For each report, data were extracted in relation to the outcomes analyzed: asthma exacerbation, asthma quality of life questionnaire scores, and forced expiratory volume in 1 second. Four assessable trials were identified including 641 patients with asthma. TNF-α antagonism therapy was superior to control therapy in preventing exacerbations in asthmatics [pooled odds ratio 0.52 (95% confidence interval 0.29-0.88), P=0.02]; however, there was a nonsignificant reduction in asthma quality of life questionnaire scores [0.23 (0 to 0.47), P=0.05], forced expiratory volume in 1 second [0.03, (-0.14 to 0.10), P=0.74] when analyzed using standardized mean differences. TNF-α antagonism was superior to control chemotherapy in terms of asthma exacerbation, but not asthma quality of life questionnaire scores or forced expiratory volume in 1 second.
肿瘤坏死因子（TNF）-α拮抗剂对哮喘是否有效仍存在争议。本荟萃分析旨在评估TNF-α拮抗剂治疗哮喘患者的疗效。检索了MEDLINE、EMBASE、LILACS和CINAHL数据库，查找截至2010年1月3日发表的英文研究。选择了比较TNF-α拮抗剂与对照疗法的随机对照试验。对于每份报告，提取与分析结果相关的数据：哮喘加重、哮喘生活质量问卷评分和1秒用力呼气量。确定了4项可评估的试验，包括641例哮喘患者。TNF-α拮抗剂治疗在预防哮喘患者病情加重方面优于对照疗法[合并比值比0.52（95%置信区间0.29 - 0.88），P = 0.02]；然而，使用标准化均数差分析时，哮喘生活质量问卷评分[0.23（0至0.47），P = 0.05]、1秒用力呼气量[0.03，（-0.14至0.10），P = 0.74]虽有下降但不显著。就哮喘加重而言，TNF-α拮抗剂优于对照化疗，但在哮喘生活质量问卷评分或1秒用力呼气量方面并非如此。
