摘要
目的采用网状Meta分析方法评价75、150和300μg三种剂量的茚达特罗治疗稳定期中重度慢性阻塞性肺疾病(COPD)的疗效和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、CBM、CNKI、WanFang Data和VIP数据库,搜集茚达特罗治疗COPD的随机对照试验(RCT),检索时限均从建库至2018年12月31日。由2名研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用ADDIS 1.16.8和Stata 15.1统计软件进行网状Meta分析。结果共纳入13个RCT,包括5 476例患者。网状Meta分析结果显示:三种剂量的茚达特罗在改善第一秒用力呼气容积(FEV1)谷值、降低圣乔治呼吸问卷(SGRQ)评分、改善呼吸困难指数(TDI)方面均优于安慰剂。150μg和300μg组减少COPD急性加重频次优于安慰剂。各组间不良反应发生率无差异。等级概率表结果提示,300μg组在改善FEV1谷值、降低SGRQ评分和改善TDI方面疗效最佳的可能性最大,在减少COPD急性加重频次方面仅次于150μg组。结论综合比较5个结局指标的网状Meta分析及排序结果显示,300μg茚达特罗在治疗稳定期中重度COPD的疗效优于75μg和150μg茚达特罗。
Objectives To assess the efficacy and safety of 3 dosages(75,150,and 300μg)of indacaterol in patients with moderate-to-severe chronic obstructive pulmonary disease(COPD)by network meta-analysis.Methods PubMed,EMbase,The Cochrane Library,CBM,CNKI,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)of indacaterol for treating stable COPD patients from inception to December 31st,2018.Two reviewers independently screened literature,extracted data and assessed the risk bias of included studies,and then ADDIS 1.16.8 and Stata 15.1 softwares were used to perform network meta-analysis.Results A total of 13 RCTs involving 5 476 patients were included.The results of network meta-analysis showed that:compared to placebo,3 dosages of indacaterol could improve trough forced expiratory volume in 1 second(trough FEV1),lower St George respiratory questionnaire(SGRQ),and improve transitional dyspnea index(TDI).150μg and 300μg groups were better than placebo group in reducing COPD exacerbation rate.There were no statistically differences between groups in incidence of all adverse effects.Ranking probability table showed that 300μg group was most likely to be the most effective treatment in improving trough FEV1,SGRQ and TDI,and it ranked second in reducing COPD exacerbation rate.Conclusions Considering the network meta-analysis and rankings,300μg indacaterol is superior to the other 2 dosages in treating the patients with moderate-to-severe COPD.
作者
侯年
施凯
李飞
刘晓菊
HOU Nian;SHI Kai;LI Fei;LIU Xiaoju(Department of Gerontal Respiratory Medicine,the First Hospital of Lanzhou University,Lanzhou,730000,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2019年第8期924-931,共8页
Chinese Journal of Evidence-based Medicine
基金
国家自然科学基金项目(项目编号:81670033)
关键词
茚达特罗
慢性阻塞性肺疾病
疗效
安全性
随机对照试验
网状Meta分析
Indacaterol
Chronic obstructive pulmonary disease
Efficacy
Safety
Randomized controlled trial
Network meta-analysis