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不同吸入性糖皮质激素治疗儿童哮喘的定量比较

Quantitative comparison of different inhaled corticosteroids in the treatment of asthma in children.

作者信息

Zhu Haoxiang, Liu Hongxia, Sui Zichao, Yu Jiesen, Zheng Qingshan, Li Lujin

机构信息

Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

Pediatr Res. 2023 Jan;93(1):31-38. doi: 10.1038/s41390-022-02095-8. Epub 2022 May 11.

Abstract

BACKGROUND

The GINA recommends inhaled corticosteroids (ICSs) for the treatment of steps 2-3 of childhood asthma. However, the difference in efficacy between these drugs remains unclear. The purpose of this study was to compare the efficacy of different ICS drugs in the treatment of childhood asthma.

METHODS

We searched PubMed and EMBASE for randomized controlled trials of ICSs in the treatment of childhood asthma. Using forced expiratory volume in the first second (FEV) as the primary outcome, a time-course model of ICSs was constructed. In addition, the symptom-free days% were analyzed as a secondary outcome.

RESULTS

Six studies involving 2237 children that reported FEV were included. The results showed that the ET50 of ciclesonide (CIC) and budesonide (BUD) was 1.23 and 2.97 weeks, respectively. Compared with them, FP had a higher efficacy. In terms of symptom-free days%, we found that the efficacy of beclometasone dipropionate was lower than that of CIC and fluticasone propionate.

CONCLUSION

In this study, the efficacy of three ICS drugs was quantitatively compared, providing necessary information for the implementation of medication guidelines for steps 2-3 of asthma in children.

IMPACT

This study analyzed the entire time-course of the drug efficacy of Inhaled corticosteroids in the treatment of asthma in children aged 5-12, which found that although the maximum efficacy of both ciclesonide and budesonide was the same, the onset speed of ciclesonide was faster than that of budesonide. The above information provides the necessary quantitative information for the implementation of medication guidelines for steps 2-3 asthma in children.

摘要

背景

全球哮喘防治创议(GINA)推荐吸入性糖皮质激素(ICSs)用于治疗儿童哮喘的第2-3级。然而,这些药物之间的疗效差异仍不明确。本研究的目的是比较不同ICS药物治疗儿童哮喘的疗效。

方法

我们在PubMed和EMBASE中检索ICSs治疗儿童哮喘的随机对照试验。以第1秒用力呼气容积(FEV)作为主要结局指标,构建ICSs的时间-过程模型。此外,将无症状天数百分比作为次要结局指标进行分析。

结果

纳入6项涉及2237名儿童且报告了FEV的研究。结果显示,环索奈德(CIC)和布地奈德(BUD)的ET50分别为1.23周和2.97周。与它们相比,氟替卡松(FP)疗效更高。在无症状天数百分比方面,我们发现丙酸倍氯米松的疗效低于CIC和丙酸氟替卡松。

结论

本研究对3种ICS药物的疗效进行了定量比较,为儿童哮喘第2-3级治疗用药指南的实施提供了必要信息。

影响

本研究分析了吸入性糖皮质激素治疗5-12岁儿童哮喘药物疗效的整个时间过程,发现虽然环索奈德和布地奈德的最大疗效相同,但环索奈德的起效速度比布地奈德快。上述信息为儿童哮喘第2-3级治疗用药指南的实施提供了必要的定量信息。

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