Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
BackgroundChronic obstructive pulmonary disease (COPD) is a chronic respiratory condition characterised by persistent respiratory symptoms and airflow limitation. Acute exacerbations punctuate the natural history of COPD and are associated with increased morbidity and mortality and disease progression. Chronic airflow limitation is caused by a combination of small airways (bronchitis) and parenchymal destruction (emphysema), which can impact day-to-day activities and overall quality of life. In carefully selected patients with COPD, long-term, prophylactic use of antibiotics may reduce bacterial load, inflammation of the airways, and the frequency of exacerbations. ObjectivesTo assess effects of different prophylactic antibiotics on exacerbations, quality of life, and serious adverse events in people with COPD in three separate network meta-analyses (NMAs), and to provide rankings of identified antibiotics. Search methodsTo identify eligible randomised controlled trials (RCTs), we searched the Cochrane Airways Group Specialised Register of trials and clinical trials registries. We conducted the most recent search on 22 January 2020. Selection criteriaWe included RCTs with a parallel design of at least 12 weeks' duration evaluating long-term administration of antibiotics prophylactically compared with other antibiotics, or placebo, for patients with COPD. Data collection and analysisThis Cochrane Review collected and updated pair-wise data from two previous Cochrane Reviews. Searches were updated and additional studies included. We conducted three separate network meta-analyses (NMAs) within a Bayesian framework to assess three outcomes: exacerbations, quality of life, and serious adverse events. For quality of life, we collected data from St George's Respiratory Questionnaire (SGRQ). Using previously validated methods, we selected the simplest model that could adequately fit the data for every analysis. We used threshold analysis to indicate which results were robust to potential biases, taking into account each study's contributions to the overall results and network structure. Probability ranking was performed for each antibiotic class for exacerbations, quality of life, and serious adverse events.Prophylactic antibiotics for adults with chronic obstructive pulmonary disease: a network meta-analysis (Review)
BackgroundChronic obstructive pulmonary disease (COPD) is a chronic respiratory condition characterised by persistent respiratory symptoms and airflow limitation. Acute exacerbations punctuate the natural history of COPD and are associated with increased morbidity and mortality and disease progression. Chronic airflow limitation is caused by a combination of small airways (bronchitis) and parenchymal destruction (emphysema), which can impact day-to-day activities and overall quality of life. In carefully selected patients with COPD, long-term, prophylactic use of antibiotics may reduce bacterial load, inflammation of the airways, and the frequency of exacerbations. ObjectivesTo assess effects of different prophylactic antibiotics on exacerbations, quality of life, and serious adverse events in people with COPD in three separate network meta-analyses (NMAs), and to provide rankings of identified antibiotics. Search methodsTo identify eligible randomised controlled trials (RCTs), we searched the Cochrane Airways Group Specialised Register of trials and clinical trials registries. We conducted the most recent search on 22 January 2020. Selection criteriaWe included RCTs with a parallel design of at least 12 weeks' duration evaluating long-term administration of antibiotics prophylactically compared with other antibiotics, or placebo, for patients with COPD. Data collection and analysisThis Cochrane Review collected and updated pair-wise data from two previous Cochrane Reviews. Searches were updated and additional studies included. We conducted three separate network meta-analyses (NMAs) within a Bayesian framework to assess three outcomes: exacerbations, quality of life, and serious adverse events. For quality of life, we collected data from St George's Respiratory Questionnaire (SGRQ). Using previously validated methods, we selected the simplest model that could adequately fit the data for every analysis. We used threshold analysis to indicate which results were robust to potential biases, taking into account each study's contributions to the overall results and network structure. Probability ranking was performed for each antibiotic class for exacerbations, quality of life, and serious adverse events.Prophylactic antibiotics for adults with chronic obstructive pulmonary disease: a network meta-analysis (Review)
Severe asthma, chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) are chronic lung diseases with a clear need for development of new and more efficient therapy. In preclinical research, the mouse model has been instrumental in advancing our knowledge of the biology and immunology. However, it has been proven rather difficult and time consuming to develop new treatments that can impact on the clinical course of these diseases. Many challenges need to be overcome for upgrading the quality of currently available experimental disease models in order to enhance the translation rate of basic research to clinical practice. Establishment of transgenic mouse overexpressing disease-causing genes may provide tools to discover new pathological pathways and to evaluate the possibility of molecular targeted therapy in chronic lung diseases. Personalized medicine, if developed, might be the solution for 'disease heterogeneity' and for improving clinical outcome.
Background: Chronic obstructive pulmonary disease (COPD) causes a major burden in terms of deaths and hospitalizations worldwide; it is associated with progressive lung function loss, and frequent exacerbations. Administration of macrolides has been considered beneficial in reducing the frequency of COPD exacerbations. The aim of this study is to assess the safety and efficacy of long-term administration of Azithromycin for patients with chronic obstructive pulmonary disease. Methods: An extensive search was conducted on SCOPUS, and PubMed databases, CENTRAL, and ClinicalTrials.gov clinical trial registers for randomized clinical trials conducted on COPD patients and administered Azithromycin for more than two weeks. The selected studies underwent assessment for the risk of bias. We conducted random-effect model meta-analysis for the frequency of acute exacerbations during follow-up as a primary outcome. Results: Out of 1021 screened records, 3 RCTs (Randomized controlled trials) involving 1264 patients were included in the final analysis. The pooled data of all 3 trials showed that administration of Azithromycin reduced the frequency of acute exacerbation of COPD [risk ratio (RR) = 0.69; 95% CI 0.53, 0.91, p = 0.01]. Subgroup analysis indicated that 500 mg Azithromycin [risk ratio (RR) =0.65; 95% CI 0.53-0.79, p=0.01] was found to be more beneficial than 250 mg Azithromycin [risk ratio (RR) = 0.60; 95% CI 0.27-1.33, p=0.21] in reducing acute exacerbation rate, however due to many limitations the analysis of the dosage was not conclusive. Conclusion: Long-term Azithromycin administration for COPD patients is statistically not associated with increased risk of developing adverse events; in addition, it might be effective in reducing the frequency of acute exacerbations of COPD. However, dosage and duration of Azithromycin administration analysis was not conclusive and thus more RCTs are needed in these areas.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.