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Rectal Organoid Morphology Analysis ROMA: A Diagnostic Assay in Cystic Fibrosis
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Nebulised hypertonic saline for cystic fibrosis
Peter Wark1, Vanessa M McDonald
1Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, 1 Kookaburra Close, New Lambton, New South Wales, Australia, 2305.
The Cochrane Database of Systematic Reviews
|September 28, 2018
Summary
Nebulized hypertonic saline improves lung function and reduces exacerbations in cystic fibrosis (CF) patients over 12 years old, though benefits may not sustain long-term. Evidence quality varies, with some treatments showing better outcomes.
Area of Science:
- Respiratory Medicine
- Pulmonology
- Clinical Trials
Background:
- Cystic Fibrosis (CF) is characterized by impaired mucociliary clearance.
- Hypertonic saline is investigated for its potential to enhance mucociliary clearance and reduce airway inflammation in CF.
- This review is an update on previous findings regarding hypertonic saline in CF management.
Purpose of the Study:
- To evaluate the efficacy and tolerability of nebulized hypertonic saline in individuals with CF.
- To compare hypertonic saline against placebo and other mucociliary clearance-enhancing treatments.
- To synthesize evidence from randomized controlled trials on hypertonic saline for CF.
Main Methods:
- Searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Register and ongoing trials databases.
- Included randomized and quasi-randomized controlled trials of hypertonic saline in CF patients of any age or severity.
- Assessed trial quality using GRADE and independently reviewed data by two authors.
Main Results:
- Hypertonic saline (3-7%) showed a small, short-term improvement in FEV1 in adults and children over 12, but this was not sustained at 48 weeks.
- Evidence suggests hypertonic saline may reduce pulmonary exacerbations, though data for children under six was insufficient.
- Comparisons with recombinant deoxyribonuclease (rhDNase) indicated rhDNase might offer better lung function improvement in some cases; other mucolytic comparisons yielded limited conclusive data.
- Adverse events like cough and chest tightness were reported, but overall evidence on safety was limited due to very low-quality data.
Conclusions:
- Nebulized hypertonic saline can improve lung function and reduce exacerbations in CF patients over 12 years old, with potential quality of life benefits for adults.
- The evidence quality for hypertonic saline's effects ranges from very low to moderate.
- Recombinant deoxyribonuclease may provide superior lung function benefits compared to hypertonic saline in certain patient groups.
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