PDF(Pubmed)
Abstract：
UNASSIGNED: The effectiveness of different combinations of inhaled corticosteroid (ICS) therapies in reducing severe exacerbations of adult asthma remains unclear.
UNASSIGNED: This network meta-analysis (NMA) extensively evaluated the treatment effects of single ICS; dual ICS i.e., ICS/long-acting β2-adrenergic agonists (LABA); ICS/LABA as single maintenance and reliever therapy (SMART); and triple ICS, i.e., ICS/LABA/long-acting muscarinic antagonists (LAMA) in preventing severe asthma exacerbations.
UNASSIGNED: A systematic search of English databases, including PubMed and Web of Science, was conducted until December 31, 2022, using PRISMA-NMA.
UNASSIGNED: Using the PICOS criteria, the questions for this study were carefully selected so that the correct keywords could be identified.
UNASSIGNED: A pairwise meta-analysis was used to select trials based on the criteria for minimizing heterogeneity (I2). Subsequently, the \"BUGSnet\" package of R software was used to perform a Bayesian network meta-analysis.
UNASSIGNED: The main outcome measures were risk rate and annualized rate ratio of severe asthma exacerbations.
UNASSIGNED: This review included 56 randomized control trials (RCTs; n = 78,171 patients). As the pairwise meta-analysis demonstrated that the annualized rate ratio of severe asthma exacerbation had moderate heterogeneity, we analyzed the risk rate of severe asthma exacerbation using a network meta-analysis. In terms of direct/indirect comparisons with non-ICS, single ICS, dual ICS, SMART, and triple ICS reduced severe asthma exacerbations by 34 %, 47 %, 58 %, and 57 %, respectively. SMART and triple ICS showed high effectiveness in reducing severe exacerbations.
UNASSIGNED: AND RELEVANCE: SMART and triple ICS were ranked higher in effectiveness in reducing severe asthma exacerbations in comparison with other therapies, indicating that these are the most effective treatments for reducing the future risk of severe asthma exacerbations.
UNASSIGNED: This network meta-analysis (NMA) extensively evaluated the treatment effects of single ICS; dual ICS i.e., ICS/long-acting β2-adrenergic agonists (LABA); ICS/LABA as single maintenance and reliever therapy (SMART); and triple ICS, i.e., ICS/LABA/long-acting muscarinic antagonists (LAMA) in preventing severe asthma exacerbations.
UNASSIGNED: A systematic search of English databases, including PubMed and Web of Science, was conducted until December 31, 2022, using PRISMA-NMA.
UNASSIGNED: Using the PICOS criteria, the questions for this study were carefully selected so that the correct keywords could be identified.
UNASSIGNED: A pairwise meta-analysis was used to select trials based on the criteria for minimizing heterogeneity (I2). Subsequently, the \"BUGSnet\" package of R software was used to perform a Bayesian network meta-analysis.
UNASSIGNED: The main outcome measures were risk rate and annualized rate ratio of severe asthma exacerbations.
UNASSIGNED: This review included 56 randomized control trials (RCTs; n = 78,171 patients). As the pairwise meta-analysis demonstrated that the annualized rate ratio of severe asthma exacerbation had moderate heterogeneity, we analyzed the risk rate of severe asthma exacerbation using a network meta-analysis. In terms of direct/indirect comparisons with non-ICS, single ICS, dual ICS, SMART, and triple ICS reduced severe asthma exacerbations by 34 %, 47 %, 58 %, and 57 %, respectively. SMART and triple ICS showed high effectiveness in reducing severe exacerbations.
UNASSIGNED: AND RELEVANCE: SMART and triple ICS were ranked higher in effectiveness in reducing severe asthma exacerbations in comparison with other therapies, indicating that these are the most effective treatments for reducing the future risk of severe asthma exacerbations.
摘要：
■吸入性皮质类固醇（ICS）治疗的不同组合在减少成人哮喘严重加重方面的有效性尚不清楚。
■此网络荟萃分析（NMA）广泛评估了单ICS的治疗效果；双ICS，即ICS/长效β2-肾上腺素能激动剂（LABA）；ICS/LABA作为单一维持和缓解疗法（SMART）；和三重ICS，即，ICS/LABA/长效毒蕈碱拮抗剂（LAMA）预防严重哮喘恶化。
■对英文数据库的系统搜索，包括PubMed和WebofScience,使用PRISMA-NMA进行到2022年12月31日。
■使用PICOS标准，这项研究的问题是经过精心选择的，以便可以识别正确的关键词。
■根据最小化异质性（I2）的标准，采用成对荟萃分析来选择试验。随后，使用R软件的“BUGSnet”软件包进行贝叶斯网络荟萃分析。
■主要结局指标是严重哮喘急性发作的风险率和年化比率。
■本综述包括56项随机对照试验（RCT；n=78,171例患者）。由于成对荟萃分析显示严重哮喘加重的年化比率具有中度异质性,我们使用网络荟萃分析分析了重度哮喘加重的风险率.就与非ICS的直接/间接比较而言，单个ICS，双ICS，聪明,和三重ICS减少了34%的严重哮喘恶化，47%,58%,57%,分别。SMART和三重ICS在减少严重加重方面显示出很高的有效性。
和相关性：与其他疗法相比，SMART和三联ICS在减少严重哮喘加重方面的有效性排名更高。表明这些是降低未来严重哮喘加重风险的最有效治疗方法.
■此网络荟萃分析（NMA）广泛评估了单ICS的治疗效果；双ICS，即ICS/长效β2-肾上腺素能激动剂（LABA）；ICS/LABA作为单一维持和缓解疗法（SMART）；和三重ICS，即，ICS/LABA/长效毒蕈碱拮抗剂（LAMA）预防严重哮喘恶化。
■对英文数据库的系统搜索，包括PubMed和WebofScience,使用PRISMA-NMA进行到2022年12月31日。
■使用PICOS标准，这项研究的问题是经过精心选择的，以便可以识别正确的关键词。
■根据最小化异质性（I2）的标准，采用成对荟萃分析来选择试验。随后，使用R软件的“BUGSnet”软件包进行贝叶斯网络荟萃分析。
■主要结局指标是严重哮喘急性发作的风险率和年化比率。
■本综述包括56项随机对照试验（RCT；n=78,171例患者）。由于成对荟萃分析显示严重哮喘加重的年化比率具有中度异质性,我们使用网络荟萃分析分析了重度哮喘加重的风险率.就与非ICS的直接/间接比较而言，单个ICS，双ICS，聪明,和三重ICS减少了34%的严重哮喘恶化，47%,58%,57%,分别。SMART和三重ICS在减少严重加重方面显示出很高的有效性。
和相关性：与其他疗法相比，SMART和三联ICS在减少严重哮喘加重方面的有效性排名更高。表明这些是降低未来严重哮喘加重风险的最有效治疗方法.
