哮喘患者长期使用吸入性糖皮质激素的安全性：一项系统评价与荟萃分析。
The safety of long-term use of inhaled corticosteroids in patients with asthma: A systematic review and meta-analysis.
作者信息
Shang Wenli, Wang Guizuo, Wang Yan, Han Dong
机构信息
Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
出版信息
Clin Immunol. 2022 Mar;236:108960. doi: 10.1016/j.clim.2022.108960. Epub 2022 Feb 24.
PURPOSE
This systematic review and meta-analysis was performed to determine the safety of long-term use of ICS in patients with asthma.
METHODS
A systematic search was made of PubMed, Embase, Web of Science, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials (RCTs) on treatment of asthma with ICS, compared with non-ICS treatment (placebo or other active drugs), were reviewed.
RESULTS
Eighty-six RCTs (enrolling 51,538 participants) met the inclusion criteria. Oral or oropharyngeal candidiasis (RR 2.58, 95% CI 2.00 to 3.33), and dysphonia/hoarseness (RR 1.56, 95% CI 1.31 to 1.85) were less frequent in the control group. There was no statistically significant difference in the risk of upper respiratory tract infection, lower respiratory tract infection, influenza, decline in bone mineral density, and fractures between the two groups.
CONCLUSION
In addition to the mild local adverse events, the long-term use of ICS was safe in patients with asthma.
目的
进行此项系统评价和荟萃分析以确定哮喘患者长期使用吸入性糖皮质激素（ICS）的安全性。
方法
对PubMed、Embase、Web of Science、Cochrane图书馆和clinicaltrials.gov进行系统检索，无语言限制。纳入比较ICS治疗哮喘与非ICS治疗（安慰剂或其他活性药物）的随机对照试验（RCT）。
结果
86项RCT（纳入51538名参与者）符合纳入标准。对照组中口腔或口咽念珠菌病（相对危险度[RR]2.58，95%置信区间[CI]2.00至3.33）和发音障碍/声音嘶哑（RR 1.56，95%CI 1.31至1.85）的发生率较低。两组在上呼吸道感染、下呼吸道感染、流感、骨密度下降和骨折风险方面无统计学显著差异。
结论
除了轻微的局部不良事件外，哮喘患者长期使用ICS是安全的。
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