药物治疗耐火或无法解释的慢性咳的有效性和安全性:系统性审查和网络元分析
Ziwen Zheng1,2,3, Junfeng Huang1,3, Ziyuan Xiang1,3
1Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou, Guangdong, China.
EClinicalMedicine
|August 4, 2023
概括
P2X3抗剂是耐火性慢性咳 (RCC) 的最有前途的治疗方法,改善生活质量并减少咳的频率. GABA调节剂也显示出有效性,但具有中枢神经系统的副作用,而TRP调节剂需要进一步研究.
科学领域:
- 药理学 药理学是指药理学的学科.
- 呼吸系统医学 呼吸系统医学
- 临床试验 临床试验
背景情况:
- 耐火性慢性咳 (RCC) 显著损害生活质量,并提出临床管理挑战.
- 对RCC的最佳药理治疗仍然存在争议,需要进行比较的疗效和安全性研究.
研究的目的:
- 系统地审查和比较RCC目前药理治疗的疗效和安全性.
- 为了确定最有效和最安全的药物类别来管理耐火性慢性咳.
主要方法:
- 贝叶斯网络对19项随机对照试验 (RCT) 的元分析,其中包括3326名患者.
- 在PubMed,Web of Science,Embase和Ovid数据库中搜索了2008年1月至2023年3月期间发表的RCT.
- 基于莱斯特咳问卷 (LCQ),视觉模拟量表 (VAS),咳频率和不良事件 (AEs) 的P2X3抗剂,GABA调节剂,TRP调节剂,NK-1激动剂,阿片类止痛药,宏类药物和酸进行了比较.
主要成果:
- 与安慰剂相比,P2X3对手在LCQ (MD: 1.637) 和24小时咳频率 (MD: -11.042) 中显著改善.
- GABA调节剂在改善LCQ (MD: 1.347) 和咳严重程度VAS (MD: -7.843) 中表现出有效性,但具有潜在的中枢神经系统AE.
- 鉴定Gefapixant (一种P2X3抗剂) 是对RCC最有效的治疗方法. P2X3对抗剂与增加的副作用有关,特别是味觉障碍.
结论:
- P2X3抗剂代表了耐火性慢性咳最有前途的药理选择,提供显著的疗效.
- GABA调节剂显示出潜力,但由于中枢神经系统的副作用,需要仔细监测.
- 需要进一步的研究来阐明TRP调节器的作用,并确定针对性治疗的最佳患者群体.
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