Abstract:
BACKGROUND:The relative efficacy of fluticasone (FP) and beclomethasone (BDP) propelled with CFCs has been well established. The potency of HFA-BDP is thought to have been improved with new propellant and some studies suggest that it may equipotent at half the dose of CFC propelled-BDP. There is a need to revisit this question in the light of a potentially more potent new non-CFC propellant. OBJECTIVES:To determine the relative efficacy of FP and HFA-propelled BDP in chronic asthma. SEARCH STRATEGY:The Cochrane Airways Group Specialised Register was searched using pre-specified terms. Searches were current as of March 2005. SELECTION CRITERIA:Randomised controlled trials were eligible for inclusion in the review. We compared either CFC or HFA-propelled FP with HFA-propelled BDP. We made a distinction between HFA-BDP and HFA-BDP extra fine, which dispenses smaller particles of drug, leading to different, usually more peripheral distribution in the airways. Any inhaler device was considered, and there was no restriction on studies with or without spacers. We included studies which assessed HFA-BDP given via either pMDI, breath-actuated MDI, or DPI. DATA COLLECTION AND ANALYSIS:Two reviewers independently assessed studies for inclusion in the review. Data were extracted and entered in to RevMan 4.2 using standard meta-analytical techniques with predefined criteria for exploring statistical heterogeneity. MAIN RESULTS:Seven studies (1230 participants) met the inclusion criteria of the review. One study was conducted in children. Study reporting quality was fair, but all studies were of short duration (three to twelve weeks). Only studies assessing HFA-BDP extra fine in comparison with FP were identified. Lung function was not significantly different between extra fine BDP and FP when compared at the same dose in parallel studies, change in FEV1: 0.04 litres (95% CI -0.03 to 0.11 litres; three studies, 659 adults); change in am PEF: -0.69 litres (95% CI -11.21 to 9.83 litres; two studies, 364 adults). Individual studies reported non-significant findings in symptom scores and quality of life questionnaires. There was no significant difference between FP and HFA-BDP in the risk of study withdrawal, dysphonia or when data were reported as any adverse event. AUTHORS' CONCLUSIONS:There was no significant difference between FP and extra fine HFA-BDP on FEV(1) or peak flow at a dose ratio of 1:1. However, the number of studies and width of the confidence intervals in the analyses do not exclude a clinically meaningful difference between these two drugs. Difficulty in the successful manipulation of the devices studied may be a barrier to the widespread use of MDIs. One paediatric study was included in the review, so extrapolation of the findings of this review to children is limited. Further longer term studies in adults and children with moderate and severe asthma are required.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Lasserson TJ,Cates CJ,Jones AB,Steele EH,White Jdoi
10.1002/14651858.CD005309.pub2keywords:
subject
Has Abstractpub_date
2005-10-19 00:00:00pages
CD005309issue
4issn
1469-493Xpub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Single-shot spinal anaesthesia (SSS) and combined spinal-epidural (CSE) anaesthesia are both commonly used for caesarean section anaesthesia. Spinals offer technical simplicity and rapid onset of nerve blockade which can be associated with hypotension. CSE anaesthesia allows for more gradual onset and also p...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD008100.pub2
更新日期:2019-10-11 00:00:00
abstract:BACKGROUND:About half of patients with Crohn's disease (CD) require surgery within 10 years of diagnosis. Resection of the affected segment is highly effective, however the majority of patients experience clinical recurrence after surgery. Most of these patients have asymptomatic endoscopic recurrence weeks or months b...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
doi:10.1002/14651858.CD012328.pub2
更新日期:2020-08-03 00:00:00
abstract:BACKGROUND:Intramedullary nails may be used for the surgical fixation of extracapsular hip fractures in adults. They may be inserted from the top (cephalocondylic) or from the bottom (condylocephalic) end of the femur. OBJECTIVES:To compare different types or design modifications of intramedullary nails used in the fi...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004961.pub3
更新日期:2006-07-19 00:00:00
abstract:BACKGROUND:General health checks are common elements of health care in some countries. They aim to detect disease and risk factors for disease with the purpose of reducing morbidity and mortality. Most of the commonly used individual screening tests offered in general health checks have been incompletely studied. Also,...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD009009.pub3
更新日期:2019-01-31 00:00:00
abstract:BACKGROUND:Scrub typhus is a cause of fever in regions of Asia and the Pacific. Recently, resistance to antibiotics has been reported. OBJECTIVES:To assess treatment regimens for scrub typhus through time to fever resolution and incidence of relapse. SEARCH STRATEGY:Cochrane Controlled Trials Register, MEDLINE, EMBAS...
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pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002150
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:The integration of HIV/AIDS and maternal, neonatal, child health and nutrition services (MNCHN), including family planning (FP) is recognized as a key strategy to reduce maternal and child mortality and control the HIV/AIDS epidemic. However, limited evidence exists on the effectiveness of service integratio...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD010119
更新日期:2012-09-12 00:00:00
abstract:BACKGROUND:Placebo interventions are often claimed to improve patient-reported and observer-reported outcomes, but this belief is not based on evidence from randomised trials that compare placebo with no treatment. OBJECTIVES:To assess the effect of placebo interventions. SEARCH STRATEGY:We searched the Cochrane Cent...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD003974.pub2
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Studies in traumatic encephalopathy first led to the insight that the damage seen was not just due to direct consequences of the primary injury. A significant, and potentially preventable, contribution to the overall morbidity arose from secondary hypoxic-ischaemic damage. Brain swelling accompanied by raise...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002043
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:About a third of women have urinary incontinence and up to a tenth have faecal incontinence after childbirth. Pelvic floor muscle training is commonly recommended during pregnancy and after birth both for prevention and treatment of incontinence. OBJECTIVES:To determine the effect of pelvic floor muscle tra...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD007471
更新日期:2008-10-08 00:00:00
abstract:BACKGROUND:The chronic hyperglycaemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels. The risk of developing type 2 diabetes increases with age, obesity, and lack of physical activity. Insulin resistance is a fu...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005525.pub2
更新日期:2007-01-24 00:00:00
abstract:BACKGROUND:Poor growth and nutritional status are common in children with chronic diseases. Oral protein calorie supplements are used to improve nutritional status in these children. These expensive products may be associated with some adverse effects, e.g. the development of inappropriate eating behaviour patterns. Th...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001914.pub2
更新日期:2015-05-27 00:00:00
abstract:BACKGROUND:Telemedicine is the use of electronic communications technology to provide care for patients when distance separates the practitioner and the patient. As the parents and families of infants admitted to the NICU require major support from health professionals in terms of information and time, telemedicine has...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD006818.pub2
更新日期:2012-06-13 00:00:00
abstract:BACKGROUND:The Nursing led inpatient Unit (NLU) is one of a range of services that have been considered in order to manage more successfully the transition between hospital and home for patients with extended recovery times. OBJECTIVES:To determine whether nursing-led inpatient units are effective in preparing patient...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002214.pub2
更新日期:2004-10-18 00:00:00
abstract:BACKGROUND:Managed withdrawal is a necessary step prior to drug-free treatment or as the end point of substitution treatment. OBJECTIVES:To assess the effectiveness of interventions involving the use of buprenorphine to manage opioid withdrawal, for withdrawal signs and symptoms, completion of withdrawal and adverse e...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002025.pub4
更新日期:2009-07-08 00:00:00
abstract:BACKGROUND:The prevalence and incidence of pain and skeletal complications of metastatic bone disease such as pathologic fractures, spinal cord compression and hypercalcemia is high and an important contributor to morbidity, poor performance status and decreased quality of life. Moreover, pathologic fractures are assoc...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006250.pub2
更新日期:2017-12-26 00:00:00
abstract:BACKGROUND:Post-thrombotic syndrome (PTS) is a long-term complication of deep venous thrombosis (DVT) that is characterised by pain, swelling, and skin changes in the affected limb. One in three patients with DVT will develop post-thrombotic sequelae within five years. Rutosides are a group of compounds derived from ho...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD005625.pub4
更新日期:2018-11-08 00:00:00
abstract:BACKGROUND:Cervical cancer is the third most common cancer world-wide. Increasing the uptake of screening, alongside increasing informed choice is of great importance in controlling this disease through prevention and early detection. OBJECTIVES:To assess the effectiveness of interventions aimed at increasing uptake, ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002834
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Cystic fibrosis is a life-limiting inherited condition which affects one in 2500 newborns in the UK and 70,000 children and adults worldwide. The condition is multifaceted and affects many systems in the body. The respiratory system is particularly affected due to a build up of thickened secretions and a pre...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD012102.pub2
更新日期:2017-12-19 00:00:00
abstract:BACKGROUND:A large proportion of patients with anxiety disorders fail to respond to first-line medication interventions, despite evidence of the effectiveness of these agents. OBJECTIVES:To assess the effects of medication versus placebo augmentation in the treatment of patients with anxiety disorders who have failed ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005473.pub2
更新日期:2006-10-18 00:00:00
abstract:BACKGROUND:Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a systemic dysfunction of mineral and bone metabolism in people with CKD. Recent research shows that phosphate retention plays a significant role in the development of CKD-MBD. Compared with drug therapies, dietary interventions may be simple, ine...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD010350.pub2
更新日期:2015-09-16 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
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更新日期:2011-08-10 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
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更新日期:2019-06-12 00:00:00
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD006282.pub4
更新日期:2012-04-18 00:00:00
abstract:BACKGROUND:Methadone is an opioid used in the management of cancer pain both in opioid naïve patients and in rotation from other opioids. A particular role in neuropathic pain has been suggested. The quest for evidence based palliative care prompted a formal appraisal of methadone in comparison with other analgesics. ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003971.pub2
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Haemophilus influenzae (H. influenzae) is an important cause of meningitis and pneumonia in children. Vaccine cost is a significant barrier to use in low income countries. Determining the size of the effects of the vaccine will enable cost-effectiveness comparisons with competing priorities in low income cou...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001729.pub3
更新日期:2009-10-07 00:00:00
abstract:BACKGROUND:One to eight per cent of women suffer third-degree perineal tear (anal sphincter injury) and fourth-degree perineal tear (rectal mucosa injury) during vaginal birth, and these tears are more common after forceps delivery (28%) and midline episiotomies. Third- and fourth-degree tears can become contaminated w...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD005125.pub4
更新日期:2014-10-07 00:00:00
abstract:BACKGROUND:For more than fifty years, low protein diets have been proposed to patients with kidney failure. However, the effects of these diets in preventing severe renal failure and the need for maintenance dialysis have not been resolved. OBJECTIVES:To determine the efficacy of low protein diets in delaying the need...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001892.pub2
更新日期:2006-04-19 00:00:00
abstract:BACKGROUND:Dental implants require sufficient bone to be adequately stabilised. For some patients implant treatment would not be an option without bone augmentation. A variety of materials and surgical techniques are available for bone augmentation. OBJECTIVES:General objectives: To test the null hypothesis of no diff...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003607.pub2
更新日期:2006-01-25 00:00:00
abstract:BACKGROUND:Salmonella infections are a common bacterial cause of invasive disease in people with sickle cell disease especially children, and are associated with high morbidity and mortality rates. Although available in some centres, people with sickle cell anaemia are not routinely immunized with salmonella vaccines. ...
journal_title:The Cochrane database of systematic reviews
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更新日期:2015-06-05 00:00:00
abstract:BACKGROUND:The explicit use of theory in research helps expand the knowledge base. Theories and models have been used extensively in HIV-prevention research and in interventions for preventing sexually transmitted infections (STIs). The health behavior field uses many theories or models of change. However, many educati...
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更新日期:2016-11-23 00:00:00