Abstract:
BACKGROUND:In cystic fibrosis (CF) airway obstruction and recurrent respiratory infection lead to inflammation, long-term lung damage, respiratory failure and death. Anti-inflammatory agents, e.g. oral corticosteroids are used since inflammation occurs early in disease. OBJECTIVES:To assess the effectiveness of oral corticosteroids in respiratory complications in CF, particularly lung function and adverse events. We examined long-term use (over 30 days) only. SEARCH STRATEGY:We searched the Cochrane CF and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Most recent search: 06 April 2011. SELECTION CRITERIA:Randomised trials comparing oral corticosteroids given for more than 30 days with placebo or no additional therapy in people with CF. DATA COLLECTION AND ANALYSIS:Two authors independently assessed study eligibility and quality. MAIN RESULTS:Of nine studies identified, three (354 participants) were included: two with four-year follow up and one with 12-weeks follow up. Data were lacking on predefined outcomes; common outcomes were examined at different time-points and presented differently. Meta-analyses were not possible.In one study, oral corticosteroids at prednisolone-equivalent dose of 1 mg/kg alternate days slowed progression of lung disease; at two and four years, % predicted FEV(1) in the 1 mg/kg group changed significantly more than in the placebo group (P < 0.02). During the first two years, the 2 mg/kg group was not significantly different from the placebo group. Linear growth retardation was observed from six months in the 2 mg/kg alternate days prednisolone group and from 24 months in the 1 mg/kg alternate days prednisolone group.Adverse events terminated one four-year study early. Year 10 follow up showed catch-up growth started two years after treatment ceased. Alternate-day treatment with oral corticosteroids may have impaired growth until adulthood in boys. AUTHORS' CONCLUSIONS:Oral corticosteroids at prednisolone-equivalent dose of 1 to 2 mg/kg alternate days appear to slow progression of lung disease in CF; benefit should be weighed against occurrence of adverse events. Risk-benefit analysis of low-dose alternate days corticosteroids is important and the short-term use of oral corticosteroids should be better evaluated.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Cheng K,Ashby D,Smyth RLdoi
10.1002/14651858.CD000407.pub2subject
Has Abstractpub_date
2011-10-05 00:00:00pages
CD000407issue
10issn
1469-493Xpub_type
杂志文章,评审abstract:BACKGROUND:The optimal timing of birth for women with an otherwise uncomplicated twin pregnancy at term is uncertain, with clinical support for both elective delivery at 37 weeks, as well as expectant management (awaiting the spontaneous onset of labour). OBJECTIVES:To assess a policy of elective delivery from 37 week...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003582
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abstract:BACKGROUND:Achilles tendinitis is one of the most common of all sports injuries. There is no consensus on treatment. OBJECTIVES:To assess the effectiveness of various treatment interventions for acute and chronic Achilles tendinitis in adults. SEARCH STRATEGY:The Cochrane Bone, Joint and Muscle Trauma Group specialis...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD000232.pub2
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doi:10.1002/14651858.CD011024.pub2
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abstract:BACKGROUND:Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated. OBJECTIVES:The objec...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005627.pub2
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doi:10.1002/14651858.CD011688.pub2
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD008783.pub3
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doi:10.1002/14651858.CD001920.pub3
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doi:10.1002/14651858.CD003063.pub2
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doi:10.1002/14651858.CD002092.pub2
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD002173.pub2
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doi:10.1002/14651858.CD011429.pub2
更新日期:2018-03-20 00:00:00
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doi:10.1002/14651858.CD005461.pub2
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD004765.pub2
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doi:10.1002/14651858.CD009101.pub2
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doi:10.1002/14651858.CD001338
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journal_title:The Cochrane database of systematic reviews
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD000563.pub5
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pub_type: 杂志文章
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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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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004125.pub2
更新日期:2006-07-19 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
doi:10.1002/14651858.CD001958.pub2
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
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pub_type: 杂志文章,meta分析,评审
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更新日期:2010-12-08 00:00:00