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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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Related in: MedlinePlus

Fluxograma da seleção de estudos. PCE: proteína catiônicaeosinofílica. PCE: proteína catiônica eosinofílica.
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f07: Fluxograma da seleção de estudos. PCE: proteína catiônicaeosinofílica. PCE: proteína catiônica eosinofílica.

Mentions: Por meio das buscas nos bancos de dados, foram identificados 223 artigos. A revisãodos títulos e resumos resultou na exclusão de 191 estudos (Figura 1). Dos 32 artigos remanescentes, alguns foram aindaexcluídos pelos seguintes motivos: ausência de informações a respeito de desfechosprimários (n = 4)(6,16); artigo de revisão ou meta-análise (n = 2)(17,18); relato de caso ou série de casos (n = 3)(7,19,20) e ausência de dados adequados para a meta-análise (n = 9; avaliação deum medicamento distinto, ausência de grupo controle ou ausência de dados pré epós-tratamento referentes ao uso de prednisona ou prednisolona).(12,21-28) Os 14 artigos remanescentes foram revisados, e apenas 8 preencheram oscritérios de inclusão.(8,10,29-34) As características dos estudos incluídos estão descritas na Tabela 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)

Fluxograma da seleção de estudos. PCE: proteína catiônicaeosinofílica. PCE: proteína catiônica eosinofílica.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f07: Fluxograma da seleção de estudos. PCE: proteína catiônicaeosinofílica. PCE: proteína catiônica eosinofílica.
Mentions: Por meio das buscas nos bancos de dados, foram identificados 223 artigos. A revisãodos títulos e resumos resultou na exclusão de 191 estudos (Figura 1). Dos 32 artigos remanescentes, alguns foram aindaexcluídos pelos seguintes motivos: ausência de informações a respeito de desfechosprimários (n = 4)(6,16); artigo de revisão ou meta-análise (n = 2)(17,18); relato de caso ou série de casos (n = 3)(7,19,20) e ausência de dados adequados para a meta-análise (n = 9; avaliação deum medicamento distinto, ausência de grupo controle ou ausência de dados pré epós-tratamento referentes ao uso de prednisona ou prednisolona).(12,21-28) Os 14 artigos remanescentes foram revisados, e apenas 8 preencheram oscritérios de inclusão.(8,10,29-34) As características dos estudos incluídos estão descritas na Tabela 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