Meta-analysis of clinical efficacy and safety of PDE4 inhibitors in the treatment of asthma patients
OBJECTIVE To systematically evaluate the efficacy and safety of phosphodiesterase 4(PDE4)inhibitors for asthma and provide evidence-based references for clinical application of this class of drugs.METHODS The Chinese and Eng-lish databases of PubMed,EMbase,Cochrane Library and China National Knowledge Infrastructure(CNKI)were searched from inceptions of database to August 2023.Literature was screened according to the inclusion and exclusion criteria.And the relevant data were extracted after methodological quality evaluations.Meta-analysis was performed with RevMan 5.4 software and sub-group analyses for examining the effects of different treatment regimens,control groups,doses and disease types on clinical out-comes.RESULTS Thirty-one randomised controlled trials(RCTs)were included with a total of 9 121 patients.Meta-analysis indicated that roflumilast group could significantly boost the clinical efficacy rate[OR=5.87,95％CI:(3.21,10.72)],enhance the volume of forceful expiration at the first second[MD=0.06,95％CI:(3.21,10.72)]and improve the volume of forceful expiration at the first second[MD=0.06,95％CI 0.06,95％CI:(0.02,0.11)]and peak expiratory flow[MD=0.53,95％CI:(0.28,0.78)].It also decreased the levels of interleukin 17[MD=-6.34,95％CI:(9.99,-2.70)],tumour necrosis factor alpha[MD=-0.14,95％CI:(-0.23,-0.05)]and also elevated the risks of such adverse events as headache[OR=3.66,95％CI:(2.26,5.93)],diarrhoea[OR=4.57,95％CI:(2.24,9.35)]and vomiting[OR=5.61,95％CI:(2.96,10.63)].In addition,no statistically significant difference existed in improvement of exertion spirometry(P＞0.05).CONCLUSION Roflu-milast is expected to be a novel anti-inflammatory drug for treating asthma.
NETL
NSTL
万方数据
