The Effect of Long-Term Azithromycin on Objective and Subjective Cough in Chronic Respiratory Disease: A Systematic Review and Meta-analysis of Randomised Controlled Trials and Noncomparative Studies.

IF 4.6 2区 医学 Q1 RESPIRATORY SYSTEM
Lung Pub Date : 2024-10-01 Epub Date: 2024-07-11 DOI:10.1007/s00408-024-00729-8
Dominic L Sykes, Pavan Mason, Nithusa Rahunathan, Simon P Hart, Alyn H Morice, Michael G Crooks
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引用次数: 0

Abstract

Introduction: Azithromycin is an effective treatment for various respiratory conditions but its effect on cough is poorly understood. We synthesised data from randomised controlled trials (RCTs) and noncomparative studies (NCT) examining its effect on objective and subjective cough.

Methods: After prospective registration on PROSPERO, we searched MEDLINE, EMBASE, and CENTRAL for both RCTs and NCT trials examining the effect azithromycin on cough in respiratory disease.

Results: We identified 1240 studies of which 6 (4 RCTs and 2 NCT studies) were included in the meta-analysis, with a total of 275 patients. Azithromycin was associated with significant improvement in Leicester Cough Questionnaire scores at follow-up when compared to baseline scores (SMD = 0.62 [95% CI 0.12 to 1.12], p = 0.01). However, when only RCTs were synthesised, no significant effect was observed (SMD = 0.12 [95% CI - 0.36 to 0.60], p = 0.62). There was no significant reduction in cough severity VAS score (SMD = - 0.39 [95% CI - 0.92 to 0.14], p = 0.15). There was no significant reduction in objective cough count (SMD = - 0.41 [95% CI - 1.04 to 0.32], p = 0.09).

Conclusion: Azithromycin therapy improves cough-related quality of life in various chronic respiratory diseases; however, there was no significant effect on cough outcomes when only data from RCTs were synthesised. We believe that to accurately identify which patients whose cough would benefit from azithromycin a large-scale clinical trial of patients with a broad spectrum of respiratory diseases, with sufficiently severe cough, should be undertaken with subgroup analysis of individual disease areas.

Abstract Image

长期服用阿奇霉素对慢性呼吸道疾病患者客观和主观咳嗽的影响:随机对照试验和非比较研究的系统回顾和元分析
简介阿奇霉素是治疗各种呼吸道疾病的有效药物,但人们对其对咳嗽的影响知之甚少。我们综合了随机对照试验(RCT)和非比较研究(NCT)的数据,研究了阿奇霉素对客观和主观咳嗽的影响:方法:在 PROSPERO 上进行前瞻性注册后,我们检索了 MEDLINE、EMBASE 和 CENTRAL 上有关阿奇霉素对呼吸道疾病咳嗽影响的 RCT 和 NCT 试验:我们确定了 1240 项研究,其中 6 项(4 项 RCT 研究和 2 项 NCT 研究)被纳入荟萃分析,共有 275 名患者参与分析。与基线分数相比,阿奇霉素与随访时莱斯特咳嗽问卷分数的显著改善有关(SMD = 0.62 [95% CI 0.12 至 1.12],p = 0.01)。然而,如果仅对研究性试验进行综合分析,则未观察到显著效果(SMD = 0.12 [95% CI - 0.36 to 0.60],p = 0.62)。咳嗽严重程度 VAS 评分没有明显降低(SMD = - 0.39 [95% CI - 0.92 to 0.14],P = 0.15)。客观咳嗽次数没有明显减少(SMD = - 0.41 [95% CI - 1.04 to 0.32],p = 0.09):结论:阿奇霉素疗法可改善各种慢性呼吸道疾病患者与咳嗽相关的生活质量;然而,仅对研究性临床试验的数据进行综合分析,对咳嗽结果并无显著影响。我们认为,为准确确定哪些咳嗽患者可从阿奇霉素中获益,应针对患有各种呼吸系统疾病且咳嗽严重的患者开展大规模临床试验,并对各个疾病领域进行亚组分析。
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来源期刊
Lung
Lung 医学-呼吸系统
CiteScore
9.10
自引率
10.00%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.
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