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囊性纤维化患者慢性鼻-鼻窦炎的医学干预措施。

Medical interventions for chronic rhinosinusitis in cystic fibrosis.

机构信息

Kasturba Medical College, Manipal University, Karnataka, India.

Department of Surgery, Kasturba Medical College and Hospital, Manipal, India.

出版信息

Cochrane Database Syst Rev. 2022 Apr 7;4(4):CD012979. doi: 10.1002/14651858.CD012979.pub3.

Abstract

BACKGROUND

Chronic rhinosinusitis frequently occurs in people with cystic fibrosis. Several medical interventions are available for treating chronic rhinosinusitis in people with cystic fibrosis; for example, different concentrations of nasal saline irrigations, topical or oral corticosteroids, antibiotics - including nebulized antibiotics - dornase alfa and modulators of the cystic fibrosis transmembrane conductance regulator (CFTR) (such as lumacaftor, ivacaftor or tezacaftor). However, the efficacy of these interventions is unclear. This is an update of a previously published review.

OBJECTIVES

The objective of this review is to compare the effects of different medical interventions in people diagnosed with cystic fibrosis and chronic rhinosinusitis.

SEARCH METHODS

We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and hand searching of journals and conference abstract books. Date of last search of trials register: 09 September 2021. We also searched ongoing trials databases, other medical databases and the reference lists of relevant articles and reviews. Date of latest additional searches: 22 November 2021.

SELECTION CRITERIA

Randomized and quasi-randomized trials of different medical interventions compared to each other or to no intervention or to placebo.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed trials identified for potential inclusion in the review. We planned to conduct data collection and analysis in accordance with Cochrane methods and to independently rate the quality of the evidence for each outcome using the GRADE guidelines.

MAIN RESULTS

We identified no trials that met the pre-defined inclusion criteria. The most recent searches identified 44 new references, none of which were eligible for inclusion in the current version of this review; 12 studies are listed as excluded and one as ongoing.

AUTHORS' CONCLUSIONS: We identified no eligible trials assessing the medical interventions in people with cystic fibrosis and chronic rhinosinusitis. High-quality trials are needed which should assess the efficacy of different treatment options detailed above for managing chronic rhinosinusitis, preventing pulmonary exacerbations and improving quality of life in people with cystic fibrosis.

摘要

背景

慢性鼻-鼻窦炎常发生于囊性纤维化患者中。囊性纤维化患者的慢性鼻-鼻窦炎有多种治疗方法,例如不同浓度的鼻腔盐水冲洗、局部或全身皮质类固醇、抗生素(包括雾化抗生素)、α-糜蛋白酶和囊性纤维化跨膜电导调节因子(CFTR)调节剂(如拉那卡福、依伐卡福或泰它卡福)。然而,这些治疗方法的疗效尚不清楚。这是一篇对先前已发表综述的更新。

目的

本综述的目的是比较诊断为囊性纤维化和慢性鼻-鼻窦炎的患者中不同医学干预措施的效果。

检索方法

我们检索了 Cochrane 囊性纤维化试验注册库,该库是通过电子数据库检索、期刊和会议摘要集手工检索编制而成。最后一次检索试验注册库的日期:2021 年 9 月 9 日。我们还检索了正在进行的试验数据库、其他医学数据库以及相关文章和综述的参考文献列表。最新的额外检索日期:2021 年 11 月 22 日。

选择标准

比较不同医学干预措施之间、与无干预或安慰剂之间的随机和准随机试验。

数据收集和分析

两名综述作者独立评估了有潜在入选可能的试验。我们计划按照 Cochrane 方法进行数据收集和分析,并根据 GRADE 指南独立评估每个结局的证据质量。

主要结果

我们没有发现符合预先确定纳入标准的试验。最近的检索发现了 44 条新的参考文献,但都不符合当前版本综述的纳入标准;12 项研究被列为排除研究,1 项研究列为正在进行。

作者结论

我们没有发现评估囊性纤维化伴慢性鼻-鼻窦炎患者医学干预措施的合格试验。需要开展高质量的试验,评估上述治疗慢性鼻-鼻窦炎、预防肺部恶化和提高囊性纤维化患者生活质量的不同治疗方案的疗效。

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本文引用的文献

2
Medical interventions for chronic rhinosinusitis in cystic fibrosis.囊性纤维化患者慢性鼻-鼻窦炎的医学干预措施。
Cochrane Database Syst Rev. 2019 Oct 23;10(10):CD012979. doi: 10.1002/14651858.CD012979.pub2.
3
Tezacaftor for the treatment of cystic fibrosis.Tezacaftor 治疗囊性纤维化。
Expert Rev Respir Med. 2018 Sep;12(9):725-732. doi: 10.1080/17476348.2018.1507741. Epub 2018 Aug 9.
5
Clinical chronic rhinosinusitis outcomes in pediatric patients with cystic fibrosis.囊性纤维化儿科患者的临床慢性鼻-鼻窦炎转归
Laryngoscope Investig Otolaryngol. 2017 May 31;2(5):276-280. doi: 10.1002/lio2.78. eCollection 2017 Oct.

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