Inhaled Corticosteroids for Bronchopulmonary Dysplasia: A Meta-analysis
| Autor: | Eric S. Shinwell, Tanja Karen, Joerg J Meerpohl, Igor Portnov, Dirk Bassler |
|---|---|
| Přispěvatelé: | University of Zurich, Shinwell, Eric S |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Context (language use) Gestational Age 610 Medicine & health Cochrane Library Placebo Risk Assessment law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Adrenal Cortex Hormones 030225 pediatrics Administration Inhalation Medicine Humans 030212 general & internal medicine 2735 Pediatrics Perinatology and Child Health Adverse effect Survival rate Bronchopulmonary Dysplasia Randomized Controlled Trials as Topic Respiratory Distress Syndrome Newborn business.industry Infant Newborn medicine.disease 10027 Clinic for Neonatology Survival Rate Treatment Outcome Bronchopulmonary dysplasia Relative risk Pediatrics Perinatology and Child Health Female business Infant Premature Follow-Up Studies |
| Zdroj: | ResearcherID |
| Popis: | CONTEXT: Bronchopulmonary dysplasia (BPD) in preterm infants remains a major health burden despite many therapeutic interventions. Inhaled corticosteroids (IC) may be a safe and effective therapy. OBJECTIVE: To assess the safety and efficacy of IC for prevention or treatment of BPD or death in preterm infants. DATA SOURCES: PubMed, the Cochrane Library, Embase, and CINAHL from their inception until November 2015 together with other relevant sources. STUDY SELECTION: Randomized controlled trials of ICs versus placebo for either prevention or treatment of BPD. DATA EXTRACTION: This meta-analysis used a random-effects model with assessment of quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS: Thirty-eight trials were identified, and 16 met inclusion criteria. ICs were associated with a significant reduction in death or BPD at 36 weeks’ postmenstrual age (risk ratio [RR] = 0.86, 95% confidence interval [CI] 0.75 to 0.99, I2 = 0%, P = .03; 6 trials, n = 1285). BPD was significantly reduced (RR = 0.77, 95% CI 0.65 to 0.91, I2 = 0%, 7 trials, n = 1168), although there was no effect on death (RR = 0.97, 95% CI 0.42 to 2.2, I2 = 50%, 7 trials, n = 1270). No difference was found for death or BPD at 28 days’ postnatal age. The use of systemic steroids was significantly reduced in treated infants (13 trials, n = 1537, RR = 0.87, 95% CI 0.76 to 0.98 I2 = 3%,). No significant differences were found in neonatal morbidities and other adverse events. LIMITATIONS: Long-term follow-up data are awaited from a recent large randomized controlled trial. CONCLUSIONS: Very preterm infants appear to benefit from ICs with reduced risk for BPD and no effect on death, other morbidities, or adverse events. Data on long-term respiratory, growth, and developmental outcomes are eagerly awaited. |
| Databáze: | OpenAIRE |
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