Will the new treatment recommendations for asthma increase adverse events?

Q4 Medicine
D. Dalin, Nicoline E. Koch, O. Hilberg
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引用次数: 0

Abstract

Summary The Global Initiative for Asthma has since 2019 recommended as-needed inhaled steroids (ICS)/formoterol either alone or in combination with ICS/long-acting β2-agonists (LABA) maintenance for mild to moderate asthma. This might give patients more adverse effects by using LABA instead of short-acting β2-agonists (SABA) and by using ICS as needed where the patient might not be able to wash their mouth after use. The objective of this study is through a literature review to investigate whether the new recommendations increase the incidence of adverse events. We included 15 randomized clinical trials. They showed no increase in adverse events with as-needed ICS/formoterol only compared with either as-needed SABA only or maintenance ICS and SABA as-needed, and even a small tendency to less adverse events. When comparing as-needed and maintenance ICS/formoterol with as-needed SABA and maintenance ICS/LABA a small increase was seen for some adverse events, especially candidiasis (1.4 vs. 0.7%) and dysphonia (1.5 vs. 1.0%). In conclusion, the new treatment with as-needed ICS/formoterol only is at least as safe as the previously recommended treatment, regarding adverse effects. ICS/formoterol used as needed and maintenance might give an increased risk of candidiasis and dysphonia, though the absolute risk remains low.
新的哮喘治疗建议会增加不良事件吗?
自2019年以来,全球哮喘倡议推荐按需吸入类固醇(ICS)/福莫特罗单独或联合ICS/长效β2激动剂(LABA)维持轻度至中度哮喘。使用LABA而不是短效β2激动剂(SABA)可能会给患者带来更多的不良影响,并且在患者使用后可能无法洗手的情况下,根据需要使用ICS。本研究的目的是通过文献综述来调查新的推荐是否会增加不良事件的发生率。我们纳入了15个随机临床试验。结果显示,与仅按需服用ICS/formoterol相比,按需服用ICS/formoterol的不良事件发生率没有增加,甚至有减少不良事件的小趋势。当比较按需和维持性ICS/福莫特罗与按需SABA和维持性ICS/LABA时,一些不良事件的发生率略有增加,特别是念珠菌病(1.4比0.7%)和语音障碍(1.5比1.0%)。总之,就不良反应而言,仅按需使用ICS/福莫特罗的新治疗至少与先前推荐的治疗一样安全。根据需要和维持使用ICS/福莫特罗可能会增加念珠菌病和语音障碍的风险,尽管绝对风险仍然很低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Adverse Drug Reaction Bulletin
Adverse Drug Reaction Bulletin Medicine-Pharmacology (medical)
CiteScore
0.70
自引率
0.00%
发文量
5
期刊介绍: For over 40 years, Adverse Drug Reaction Bulletin has provided comprehensive coverage in the field of adverse drug reactions. Each issue contains an invited article on a topic of current interest, dealing with specific conditions from drug-induced lung disorders to drug-induced sexual dysfunction, or types of drugs from lipid-lowering agents to poisons antidotes. This bimonthly journal"s articles are timely, succinct and fully referenced
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