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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

plots. MD: median; ECP: eosinophil cationic protein; and BD:bronchodilator.
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f06: plots. MD: median; ECP: eosinophil cationic protein; and BD:bronchodilator.

Mentions: Because of the high heterogeneity, we conducted a meta-regression to examine theeffects of treatment with prednisone or prednisolone by age, gender, and dose (Figure 6). The prednisone dose appeared to beresponsible for the heterogeneity in sputum eosinophil counts (T2 = 8.753)and ECP (T2 = 172.8). Linear regression did not show an associationbetween prednisone dose and sputum eosinophils (p = 0.55), sputum ECP (p = 0.38),sputum IL-5 (p = 1.00) or post-bronchodilator FEV1 (p = 0.27).


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)

plots. MD: median; ECP: eosinophil cationic protein; and BD:bronchodilator.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f06: plots. MD: median; ECP: eosinophil cationic protein; and BD:bronchodilator.
Mentions: Because of the high heterogeneity, we conducted a meta-regression to examine theeffects of treatment with prednisone or prednisolone by age, gender, and dose (Figure 6). The prednisone dose appeared to beresponsible for the heterogeneity in sputum eosinophil counts (T2 = 8.753)and ECP (T2 = 172.8). Linear regression did not show an associationbetween prednisone dose and sputum eosinophils (p = 0.55), sputum ECP (p = 0.38),sputum IL-5 (p = 1.00) or post-bronchodilator FEV1 (p = 0.27).

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