吸入性皮质类固醇的局部和全身不良影响 - 环胺与其他吸入性皮质类固醇有区别吗?
Thera Gram Ottesen1, Alma Holm Rovsing1, Charlotte Suppli Ulrik2
1Respiratory Research Unit Hvidovre, Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Denmark.
在喘患者中,西克莱索尼德可能会提供较少的局部不良影响. 有证据表明,在系统性作用方面,环索尼德对其他吸入性皮质类固醇有利或类似,尽管研究结果是相互矛盾的.
科学领域:
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 吸入性皮质类固醇 (ICS) 是标准的喘治疗方法.
- 西克莱索尼德的简介表明潜在的副作用可能较低.
- 需要对克莱索尼德的比较安全数据进行更新的审查.
研究的目的:
- 系统地审查氏的局部和全身不良影响与喘中的其他ICS相比.
- 提供关于环索尼德安全概况的最新证据.
主要方法:
- 在遵守PRISMA指南的基础上进行系统审查.
- 搜索医疗主题标题 (MeSH) 术语:环索尼德和喘.
- 包括28项研究从296个初次成功中,最后更新于2024年9月.
主要成果:
- 15/25的研究显示了微不足道的局部不良影响差异;7个RCT表明,使用环胺降低了局部风险.
- 在九项试验中,有七项试验没有发现克莱索尼德可以抑制尿中皮质醇,这与比较性ICS不同.
- 在白内障风险上没有显著的差异; 一项研究偏爱循环索尼德而不是流他 propionate 对于视力恶化.
结论:
- 与其他ICS相比,关于赛克莱索尼德的不良影响的证据是矛盾的.
- 一些证据有利于循环索尼德减少局部不良影响.
- 在系统性不良影响方面,西克莱索尼德似乎有利或与其他ICS相似.
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