A systematic review and meta-analysis of the treatment modalities available for children afflicted from cystic fibrosis.

IF 2 3区 医学 Q2 PEDIATRICS
Thamer Alshami Marghel Alruwaili, Muhannad Faleh Alanazi, Bashayer Farhan Alruwaili, Hamada K Fayed, Mahmoud Elsaeed, Talal Difallah Alnazi, Ahmad Aljared, Aasheq M W Alanazi, Abdulrahman M Alanazi, Saleh Dhifallah Alsharari, Amirah Alshammari, Khaled Saad
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Abstract

Background: This study aimed to evaluate the efficacy of different treatment modalities in children with cystic fibrosis (CF) and determine the superiority of specific treatment modalities.

Methods: A comprehensive literature search was conducted using different search strings across multiple databases, including PubMed, Cochrane Library, EMBASE, WOS, Scopus, CINAHL, PsycINFO, and Google Scholar, up to October 2024. Randomized controlled trials (RCTs), case-control studies and cohort studies were included.

Results: The triple therapy indicated a significant reduction in CF-related complications, with an OR of 0.29 and an RR of 0.54, accompanied by low heterogeneity (I² = 0% for both). Physiotherapy and pulmonary exercises also yielded a beneficial effect, with an OR of 0.24 and an RR of 0.49, without heterogeneity. In contrast, nutritional interventions revealed non-significant outcomes (OR = 6.91 and RR = 2.63), suggesting the need to re-evaluate these strategies. Ivacaftor alone did not achieve statistical significance (OR = 0.34 and RR = 0.58), and the confidence intervals were broad, indicating uncertainty in the effect estimates. Azithromycin exhibited a positive effect on CF management, with an OR of 2.37 and an RR of 1.54. The overall pooled OR across all treatments was 0.71, with an RR not computed due to substantial heterogeneity (I²=93%).

Conclusion: The study underscores the effectiveness of certain treatments, such as triple therapy and physiotherapy exercises, for CF while highlighting the considerable variability in treatment outcomes. Notably, nutritional interventions need to be carefully reassessed. The findings emphasize integrating physiotherapy and targeted pharmacological interventions into standard CF management tailored to individual needs.

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对儿童囊性纤维化可用治疗方式的系统回顾和荟萃分析。
背景:本研究旨在评价不同治疗方式对儿童囊性纤维化(CF)的疗效,确定特定治疗方式的优越性。方法:对截至2024年10月的PubMed、Cochrane Library、EMBASE、WOS、Scopus、CINAHL、PsycINFO、谷歌Scholar等多个数据库进行不同检索字符串的综合文献检索。包括随机对照试验(RCTs)、病例对照研究和队列研究。结果:三联疗法显著减少了cf相关并发症,OR为0.29,RR为0.54,异质性较低(两者的I²= 0%)。物理治疗和肺部锻炼也产生了有益的效果,OR为0.24,RR为0.49,没有异质性。相比之下,营养干预显示无显著结果(OR = 6.91, RR = 2.63),表明需要重新评估这些策略。单独使用Ivacaftor未达到统计学意义(OR = 0.34, RR = 0.58),且置信区间较宽,表明效果估计存在不确定性。阿奇霉素对CF管理有积极作用,OR为2.37,RR为1.54。所有治疗的总合并OR为0.71,由于异质性较大(I²=93%),未计算RR。结论:该研究强调了某些治疗方法的有效性,如三联疗法和物理治疗运动,同时强调了治疗结果的相当大的可变性。值得注意的是,需要仔细重新评估营养干预措施。研究结果强调将物理治疗和有针对性的药物干预纳入针对个体需求的标准CF管理。
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来源期刊
BMC Pediatrics
BMC Pediatrics PEDIATRICS-
CiteScore
3.70
自引率
4.20%
发文量
683
审稿时长
3-8 weeks
期刊介绍: BMC Pediatrics is an open access journal publishing peer-reviewed research articles in all aspects of health care in neonates, children and adolescents, as well as related molecular genetics, pathophysiology, and epidemiology.
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