Lancet respir med:长期使用大环内酯类药物可降低支气管扩张患者恶化风险

2019-08-13 MedSci MedSci原创

研究发现,长期大环内酯治疗可显著降低支气管扩张患者恶化频率

支气管扩张治疗指南推荐每年三次以上恶化,无铜绿假单胞菌感染人群长期使用大环内酯治疗并预防支气管扩张患者病情恶化。近日研究人员开展系统回顾和患者个人数据(IPD)荟萃分析,以探讨大环内酯类药物的治疗收益。

研究人员收集截至2018年9月30日,大环内酯类抗生素在成年支气管扩张患者中的双盲、随机、安慰剂对照试验。Meta分析的主要终点为需要使用抗生素治疗的恶化频率。次要终点是首次恶化的时间、圣乔治呼吸问卷(SGRQ)的生活质量变化以及FEV1的变化。

研究收集了3项随机对照试验, 341名参与者的IPD。大环内酯类药物降低了病情恶化发生率(校正后的发病率比[IRR]0.49)。大环内酯治疗可以改善首次加重发作的时间(调整后的危险比0.46),并与SGRQ测定的生活质量改善有关(平均改善2.93分),但与FEV1的显著改善无关。亚组分析显示,所有预先指定亚组的恶化频率均降低,包括P铜绿杆菌感染患者(IRR:0.36)和每年1-2次加重的患者(0.37)。研究偏差风险较低。

研究发现,长期大环内酯治疗可显著降低支气管扩张患者恶化频率。

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    2019-12-16 lsj637
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    2019-11-11 howi
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