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Published on: August 7, 2017
Effectiveness of polyvalent bacterial lysate for pediatric asthma control: a retrospective propensity score-matched
1Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China.
Insights
Polyvalent bacterial lysate Qipian improved pediatric asthma control and reduced exacerbations in a real-world study. Further research is needed to confirm its efficacy and understand its mechanisms.
Area of Science:
- Pediatric Pulmonology
- Immunology
- Pharmacology
Background:
- Previous research indicates bacterial lysates are effective for pediatric asthma.
- Limited evidence exists for the efficacy of polyvalent bacterial lysate Qipian in children.
Purpose of the Study:
- To evaluate the effectiveness of polyvalent bacterial lysate Qipian in improving pediatric asthma control and reducing exacerbations.
- To assess the safety and impact of Qipian on medication use in children with asthma.
Main Methods:
- A real-world retrospective cohort study included children aged six months to 14 years with asthma.
- Propensity score matching was used to minimize confounders between the Qipian group and the control group.
- Asthma control, exacerbation rates, short-acting beta-agonist use, and respiratory infections were compared.
Main Results:
- Qipian group showed significantly better asthma control (P=0.004) and fewer poorly controlled cases.
- Reduced risks of exacerbations were observed in the Qipian group (IRR for severe exacerbations: 0.09 at 3 months).
- Qipian use led to lower short-acting beta-agonist cumulative doses and fewer antibacterial prescriptions.
Conclusions:
- Polyvalent bacterial lysate Qipian may improve pediatric asthma control.
- Further investigation into Qipian's safety profile and mechanisms of action is warranted.
- Randomized controlled trials are recommended to validate these findings.
Background:
Previous studies showed bacterial lysates were effective for pediatric asthma. However, evidence of polyvalent bacterial lysate Qipian is lacking.
Methods:
In this real-world retrospective cohort study, data of children with asthma, aged six months to 14 years old, attending to Jiangxi Provincial Children's Hospital from January 2021 to April 2022, prescribed routine treatment for asthma plus Qipian (Qipian group) or not (control group) were extracted. To minimize the impact of confounders on the outcomes, baseline characteristics were utilized to perform propensity score matching through a multivariable logistic regression model. After matching, asthma control, exacerbation, etc. were compared.
Results:
Totally, 795 patients were included (337 in the Qipian group and 458 in the control group), with 278 pairs (556 patients) matched. Most baseline characteristics were well-balanced. The proportion of males were 68.3% and 70.1% in the two groups. The Qipian group favored better asthma control, with more "controlled" [3-month: 257 (92.4%) vs. 240 (86.3%); 6-month: 246 (88.5%) vs. 235 (84.5%)], and fewer "poorly/very poorly controlled" patients, compared with the control group (P=0.004 and 0.025, respectively). Patients in the Qipian group had lower risks of exacerbation. Incidence rate ratios (IRR) for any exacerbation were 0.56 [95% confidence interval (CI): 0.33 to 0.93] in the 3-month period and 0.83 (95% CI: 0.55 to 1.26) in the 6-month period. IRR for severe exacerbations were 0.09 (95% CI: 0.01 to 0.71) in the 3-month period and 0.20 (95% CI: 0.06 to 0.70) in the 6-month period (compared to the control group). Qipian significantly reduced the cumulative dose of short-acting beta-agonist (3-month: 3.22±10.37 vs. 8.08±16.71 mg; P<0.001; 6-month: 6.56±16.23 vs. 11.81±24.41 mg; P=0.002). There was no difference in incidences of respiratory tract infection or fever due to respiratory tract infection between the two groups. Numbers of antibacterial agent prescription were fewer in the Qipian group compared to the control group (3-month: 0.67±1.16 vs. 1.04±1.45; P=0.001; 6-month: 1.14±1.69 vs. 1.51±2.12; P=0.023).
Conclusions:
According to this retrospective study, Qipian may be effective for improved pediatric asthma control. Safety profile and mechanisms of action of Qipian need further investigation. Further randomized controlled trials are warranted to confirm our results.
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