雾化器系统用于囊性纤维化患者的药物输送
Gemma Stanford1, Lisa Morrison2, Catherine Brown3
1Department of Adult Cystic Fibrosis, Royal Brompton Hospital, Guys and St Thomas's NHS Foundation Trust, London, UK.
The Cochrane database of systematic reviews
|November 9, 2023
概括
像适应性气溶输送 (AAD) 和振动网技术 (VMT) 这样的新型雾化器系统为囊性纤维化 (CF) 患者提供更快的治疗时间和更好的药物沉积. 然而,需要更多的研究来确定个人患者需求的总体最佳系统.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 医疗器械 医疗器械
- 药理学 药理学是指药理学的学科.
背景情况:
- 雾化器系统对于输送吸入药物来管理囊性纤维化 (CF) 肺病至关重要.
- 有许多雾化器系统和吸入药物,使用许可证各不相同.
- 本系统性审查是对CF患者的雾化器系统进行比较的最新情况.
研究的目的:
- 评估CF的不同雾化器系统的时间效率,有效性,安全性,成本和对生活质量 (QoL) 的影响.
- 为了比较各种雾化器技术,包括传统的振动网技术 (VMT) 和自适应性气溶输送 (AAD) 系统.
- 评估这些系统与CF患者的不同吸入药物一起使用时.
主要方法:
- 进行了随机对照试验 (RCT) 和准RCT的系统审查.
- 搜索了多个数据库,试验注册表,并与制造商联系,寻找已公布和未公布的数据.
- 包括比较传统,VMT,AAD和超声波雾化系统的研究.
主要成果:
- 33项研究 (2270名参与者) 通过不同的雾化器比较了托布拉米辛,胆固醇素,多尔纳酶α和高血压盐水.
- 与传统系统相比,较新的AAD和VMT系统减少了治疗时间,改善了药物沉积.
- 证据的确定性从低到非常低;较新的系统在适当的启动剂量下看起来是安全的,患者的偏好/坚持可能会改善,但系统故障是令人担忧的.
结论:
- 与传统系统相比,AAD和VMT雾化器系统在处理时间,沉积,偏好和粘附性方面具有优势.
- 对于各种CF药物和雾化剂组合,存在显著的数据缺口,需要长期的RCT.
- 没有足够的证据证明一个雾化器系统总体上优越;个性化的患者-临床医生选择至关重要.
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