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Effects of prednisone on eosinophilic bronchitis in asthma: a systematic review and meta-analysis.

Sakae TM, Maurici R, Trevisol DJ, Pizzichini MM, Pizzichini E - J Bras Pneumol (2014)

Bottom Line: The independent variables were the use, dose, and duration of prednisone treatment.The pooled analysis of the pre- vs. post-treatment data revealed a significant mean reduction in sputum eosinophils (↓8.18%; 95% CI: 7.69-8.67; p < 0.001), sputum IL-5 (↓83.64 pg/mL; 95% CI: 52.45-114.83; p < 0.001), and sputum ECP (↓267.60 µg/L; 95% CI: 244.57-290.63; p < 0.0001), as well as a significant mean increase in post-bronchodilator FEV1 (↑8.09%; 95% CI: 5.35-10.83; p < 0.001).This reduction in the inflammatory response was accompanied by a significant increase in post-bronchodilator FEV1.

View Article: PubMed Central - PubMed

Affiliation: Federal University of Santa Catarina, Florianópolis, Brazil.

ABSTRACT

Objective: To evaluate the effect size of oral corticosteroid treatment on eosinophilic bronchitis in asthma, through systematic review and meta-analysis.

Methods: We systematically reviewed articles in the Medline, Cochrane Controlled Trials Register, EMBASE, and LILACS databases. We selected studies meeting the following criteria: comparing at least two groups or time points (prednisone vs. control, prednisone vs. another drug, or pre- vs. post-treatment with prednisone); and evaluating parameters before and after prednisone use, including values for sputum eosinophils, sputum eosinophil cationic protein (ECP), and sputum IL-5-with or without values for post-bronchodilator FEV1-with corresponding 95% CIs or with sufficient data for calculation. The independent variables were the use, dose, and duration of prednisone treatment. The outcomes evaluated were sputum eosinophils, IL-5, and ECP, as well as post-bronchodilator FEV1.

Results: The pooled analysis of the pre- vs. post-treatment data revealed a significant mean reduction in sputum eosinophils (↓8.18%; 95% CI: 7.69-8.67; p < 0.001), sputum IL-5 (↓83.64 pg/mL; 95% CI: 52.45-114.83; p < 0.001), and sputum ECP (↓267.60 µg/L; 95% CI: 244.57-290.63; p < 0.0001), as well as a significant mean increase in post-bronchodilator FEV1 (↑8.09%; 95% CI: 5.35-10.83; p < 0.001).

Conclusions: In patients with moderate-to-severe eosinophilic bronchitis, treatment with prednisone caused a significant reduction in sputum eosinophil counts, as well as in the sputum levels of IL-5 and ECP. This reduction in the inflammatory response was accompanied by a significant increase in post-bronchodilator FEV1.

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Flowchart of study selection. ECP: eosinophil cationic protein.
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f01: Flowchart of study selection. ECP: eosinophil cationic protein.

Mentions: Through the database searches, we identified a total of 223 articles. Upon review of thetitles and abstracts, we excluded 191 studies (Figure1). Among the remaining 32 articles, some were further excluded: for lackingany information on primary outcomes (n = 4),(6,16) for being a review article or meta-analysis (n = 2),(17,18) for being a case report or case series (n = 3),(7,19,20) or for lacking adequate data for the meta-analysis (n = 9; evaluating adifferent drug, lacking a control group, or lacking pre- and post-treatment data relatedto the use of prednisone or prednisolone). (12,21-28) We reviewed the remaining 14 articles and found that only 8 met theinclusion criteria.(8,10,29-34) The characteristics of the included studies are presented in Table 1.


Effects of prednisone on eosinophilic bronchitis in asthma: a systematic review and meta-analysis.

Sakae TM, Maurici R, Trevisol DJ, Pizzichini MM, Pizzichini E - J Bras Pneumol (2014)

Flowchart of study selection. ECP: eosinophil cationic protein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263337&req=5

f01: Flowchart of study selection. ECP: eosinophil cationic protein.
Mentions: Through the database searches, we identified a total of 223 articles. Upon review of thetitles and abstracts, we excluded 191 studies (Figure1). Among the remaining 32 articles, some were further excluded: for lackingany information on primary outcomes (n = 4),(6,16) for being a review article or meta-analysis (n = 2),(17,18) for being a case report or case series (n = 3),(7,19,20) or for lacking adequate data for the meta-analysis (n = 9; evaluating adifferent drug, lacking a control group, or lacking pre- and post-treatment data relatedto the use of prednisone or prednisolone). (12,21-28) We reviewed the remaining 14 articles and found that only 8 met theinclusion criteria.(8,10,29-34) The characteristics of the included studies are presented in Table 1.

Bottom Line: The independent variables were the use, dose, and duration of prednisone treatment.The pooled analysis of the pre- vs. post-treatment data revealed a significant mean reduction in sputum eosinophils (↓8.18%; 95% CI: 7.69-8.67; p < 0.001), sputum IL-5 (↓83.64 pg/mL; 95% CI: 52.45-114.83; p < 0.001), and sputum ECP (↓267.60 µg/L; 95% CI: 244.57-290.63; p < 0.0001), as well as a significant mean increase in post-bronchodilator FEV1 (↑8.09%; 95% CI: 5.35-10.83; p < 0.001).This reduction in the inflammatory response was accompanied by a significant increase in post-bronchodilator FEV1.

View Article: PubMed Central - PubMed

Affiliation: Federal University of Santa Catarina, Florianópolis, Brazil.

ABSTRACT

Objective: To evaluate the effect size of oral corticosteroid treatment on eosinophilic bronchitis in asthma, through systematic review and meta-analysis.

Methods: We systematically reviewed articles in the Medline, Cochrane Controlled Trials Register, EMBASE, and LILACS databases. We selected studies meeting the following criteria: comparing at least two groups or time points (prednisone vs. control, prednisone vs. another drug, or pre- vs. post-treatment with prednisone); and evaluating parameters before and after prednisone use, including values for sputum eosinophils, sputum eosinophil cationic protein (ECP), and sputum IL-5-with or without values for post-bronchodilator FEV1-with corresponding 95% CIs or with sufficient data for calculation. The independent variables were the use, dose, and duration of prednisone treatment. The outcomes evaluated were sputum eosinophils, IL-5, and ECP, as well as post-bronchodilator FEV1.

Results: The pooled analysis of the pre- vs. post-treatment data revealed a significant mean reduction in sputum eosinophils (↓8.18%; 95% CI: 7.69-8.67; p < 0.001), sputum IL-5 (↓83.64 pg/mL; 95% CI: 52.45-114.83; p < 0.001), and sputum ECP (↓267.60 µg/L; 95% CI: 244.57-290.63; p < 0.0001), as well as a significant mean increase in post-bronchodilator FEV1 (↑8.09%; 95% CI: 5.35-10.83; p < 0.001).

Conclusions: In patients with moderate-to-severe eosinophilic bronchitis, treatment with prednisone caused a significant reduction in sputum eosinophil counts, as well as in the sputum levels of IL-5 and ECP. This reduction in the inflammatory response was accompanied by a significant increase in post-bronchodilator FEV1.

Show MeSH
Related in: MedlinePlus