糠酸氟替卡松/维兰特罗治疗中重度慢性阻塞性肺疾病的Meta分析

Futicasone furoate/vilanterol for treatment of moderate to severe chronic obstructive pulmonary disease:a Meta-analysis

目的探讨糠酸氟替卡松/维兰特罗(FF/VI)治疗方案治疗中重度慢性阻塞性肺疾病(COPD)的有效性及安全性。方法计算机检索Pub Med、EMbase、Cochrane Library、中国知网、维普网和万方数据库,搜集比较FF/VI与慢性阻塞性肺疾病全球倡仪(GOLD)推荐的其他吸入性糖皮质激素/长效β2激动剂(ICS/LABA)或长效抗胆碱能吸入剂治疗中重度COPD疗效的随机对照试验(RCTs),筛选文献、提取资料后,评价文献质量。采用Stata14.0软件进行Meta分析。结果共纳入4个RCTs,共3 266例患者。Meta分析结果显示:FF/VI在改善患者1秒用力呼气容积方面优于GOLD推荐的其他ICS/LABA及长效抗胆碱能吸入剂(P<0.05);两种方案的总体不良反应发生率、常见不良反应(关节炎、头痛、腰痛、口腔真菌感染)发生率比较,差异均无统计学意义(P>0.05)。结论采用FF/VI 100/25μg 1次/d的治疗方案维持治疗中重度COPD,能明显改善患者肺功能,安全性与GOLD推荐的其他治疗方案相似。

Objective To explore the effectiveness and safety of fluticasone furoate/vilanterol versus（ FF/VI） for the treatments of moderate to severe chronic obstructive pulmonary disease（ COPD）. Methods The databases of computer retrieve included Pub Med,EMbase,Cochrane Library,CNKI,VIP and Wan Fang Database. The randomized controlled trials（ RCTs） about the comparison of efficacy between FF/VI and other inhaled corticosteroid/long-acting beta2-agonist（ ICS/LABA） or long-acting inhaled anticholinergics recommended by Global Initiative for Chronic Obstructive Disease（ GOLD） for moderate to severe COPD were collected. The quality assessment of the literatures was conducted after literature screening and data extraction. Then Meta analysis was performed by Stata 14. 0 software. Results Four RCTs were involved,which consisted of 3266 patients The results of Meta-analysis showed that the improvement of force expiratory volume in one second by FF/IV was superior to that by other ICS/LABA and long-acting inhaled anticholinergics recommended by GOLD（ P〈0. 05）,but there were no statistical differences in the overall incidence rate of adverse effects or incidence rates of common adverse effects（ including arthritis,headache,back pain and oral candidiasis） between the two approaches（ P〉0. 05）. Conclusion For the maintenance treatment of moderate to severe COPD,FF/IV（ 100/25 μg for once per day） can improve patients＇ lung function significantly,and can obtain the similar safety as the other therapeutic regimens recommended by GOLD.