Inhaled fluticasone propionate for chronic asthma.


BACKGROUND:Inhaled fluticasone propionate (FP) is a relatively new inhaled corticosteroid for the treatment of asthma. OBJECTIVES:1. To assess efficacy and safety outcomes in studies that compared FP to placebo for treatment of chronic asthma. 2. To explore the presence of a dose-response effect. SEARCH STRATEGY:We searched the Cochrane Airways Group Trial Register (1999), reference lists of articles, contacted trialists and searched abstracts of major respiratory society meetings (1997-1999). SELECTION CRITERIA:Randomised trials in children and adults comparing FP to placebo in the treatment of chronic asthma. Two reviewers independently assessed articles for inclusion and methodological quality. DATA COLLECTION AND ANALYSIS:One reviewer extracted data. Quantitative analyses where undertaken using Review Manager 4.0.3 with MetaView 3.1. MAIN RESULTS:28 studies were selected for inclusion (5788 subjects). Methodological quality was high. In non-oral steroid treated asthmatics with mild-moderate disease FP produced improvements from baseline compared to placebo: FEV1 Weighted Mean Difference (WMD) 0.31 litres (95% confidence interval (CI) 0.27 to 0.36 litres); morning PEF WMD 29 /min (95% CI 24 to 33 L/min); symptom scores Standardised Mean Difference (SMD) 0.59 (95% CI 0.47 to 0.71); reduction in rescue beta2 agonist use WMD 1.1 puffs/d (95% CI 0.9 to 1.4). Similar effects were seen for all doses up to 1000 mcg/d. A shallow dose response effect was apparent: eg change in morning PEF with FP 1000 mcg/d WMD 49 L/min (95% CI 41 to 58 L/min). High dose FP reduced the number of patients dependent on prednisolone: FP 1000-1500 mcg/d Peto Odds Ratio 0.07 (95% CI 0.05 to 0.10). FP at all doses led to a greater likelihood of sore throat, hoarseness and oral Candidiasis. REVIEWER'S CONCLUSIONS:Doses of FP in the range 100-1000 mcg/d are effective. Although there appears to be a dose-response effect, in most patients with mild-moderate asthma improvements with low dose FP are only a little less than those with high doses. High dose FP appears to have worthwhile oral-corticosteroid reducing properties. FP use is accompanied by an increased likelihood of oropharyngeal side effects and this appears to be dose dependent.


Adams N,Bestall J,Jones PW





Has Abstract


2001-01-01 00:00:00










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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Head K,Chong LY,Bhutta MF,Morris PS,Vijayasekaran S,Burton MJ,Schilder AG,Brennan-Jones CG

    更新日期:2020-01-06 00:00:00

  • Electroconvulsive therapy for schizophrenia.

    abstract:BACKGROUND:Electroconvulsive therapy (ECT) involves the induction of a seizure (fit) for therapeutic purposes by the administration of a variable frequency electrical stimulus shock via electrodes applied to the scalp. The effects of its use in people with schizophrenia are unclear. OBJECTIVES:To determine whether ele...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Tharyan P,Adams CE

    更新日期:2002-01-01 00:00:00

  • Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children.

    abstract:BACKGROUND:Mental health problems in children are common. Research suggests that parenting has an important role to play in helping children to become well adjusted adults, and that the first few months and years of a child's life are especially important in establishing patterns of emotional, cognitive and social func...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Barlow J,Parsons J

    更新日期:2002-01-01 00:00:00

  • Empiric antibiotic coverage of atypical pathogens for community-acquired pneumonia in hospitalized adults.

    abstract:BACKGROUND:Community-acquired pneumonia (CAP) is caused by various pathogens, traditionally divided into 'typical' and 'atypical'. Initial antibiotic treatment of CAP is usually empirical, customarily covering both typical and atypical pathogens. To date, no sufficient evidence exists to support this broad coverage, wh...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Eliakim-Raz N,Robenshtok E,Shefet D,Gafter-Gvili A,Vidal L,Paul M,Leibovici L

    更新日期:2012-09-12 00:00:00

  • Lithium for schizophrenia.

    abstract:BACKGROUND:Many people with schizophrenia do not achieve a satisfactory treatment response with ordinary antipsychotic drug treatment. In these cases, various add-on medications are used, among them lithium. OBJECTIVES:To review the effects of lithium for the treatment of schizophrenia and schizophrenia-like psychoses...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Leucht S,McGrath J,Kissling W

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  • Immunotherapy for IgM anti-Myelin-Associated Glycoprotein paraprotein-associated peripheral neuropathies.

    abstract:BACKGROUND:Serum monoclonal anti-Myelin Associated Glycoprotein antibodies may be pathogenic in some patients with IgM paraprotein and demyelinating neuropathy. Immunotherapies aimed at reducing the level of these antibodies might be expected to be of benefit in the treatment of the neuropathy. Many potential therapies...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Lunn MP,Nobile-Orazio E

    更新日期:2003-01-01 00:00:00

  • Antispasmodics for labour.

    abstract:BACKGROUND:Prolonged labour can lead to increased maternal and neonatal mortality and morbidity due to increased risks of maternal exhaustion, postpartum haemorrhage and sepsis, fetal distress and asphyxia and requires early detection and appropriate clinical response. The risks for complications of prolonged labour ar...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Rohwer AC,Khondowe O,Young T

    更新日期:2013-06-05 00:00:00

  • WITHDRAWN: Anticoagulants or antiplatelet therapy for non-rheumatic atrial fibrillation and flutter.

    abstract:BACKGROUND:Atrial fibrillation (AF) carries a high risk of stroke and other thromboembolic events. Appropriate use of drugs to prevent thromboembolism in patients with AF involves comparing the patient's risk of stroke to the risk of hemorrhage from medication use. OBJECTIVES:To quantify risk of stroke, major hemorrha...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Segal JB,McNamara RL,Miller MR,Powe NR,Goodman SN,Robinson KA,Bass EB

    更新日期:2007-07-18 00:00:00

  • Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth.

    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

    pub_type: 杂志文章,评审


    authors: Buppasiri P,Lumbiganon P,Thinkhamrop J,Thinkhamrop B

    更新日期:2014-10-07 00:00:00

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    abstract:BACKGROUND:Genital infections caused by Chlamydia trachomatis are the most prevalent bacterial sexually transmitted infection worldwide. Screening of sexually active young adults to detect and treat asymptomatic infections might reduce chlamydia transmission and prevent reproductive tract morbidity, particularly pelvic...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Low N,Redmond S,Uusküla A,van Bergen J,Ward H,Andersen B,Götz H

    更新日期:2016-09-13 00:00:00

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    更新日期:2015-05-27 00:00:00

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    abstract:BACKGROUND:Laws restricting sales of tobacco products to minors exist in many countries, but young people may still purchase cigarettes easily. OBJECTIVES:The review assesses the effects of interventions to reduce underage access to tobacco by deterring shopkeepers from making illegal sales. SEARCH STRATEGY:We search...

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    authors: Stead LF,Lancaster T

    更新日期:2005-01-25 00:00:00

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    abstract:BACKGROUND:Urinary tract infection (UTI) is the most common hospital-acquired infection. The major associated cause is indwelling urethral catheters. Several measures have been introduced to reduce catheter-associated urinary tract infections (CAUTIs). One of these measures is the introduction of specialised urethral c...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Lam TB,Omar MI,Fisher E,Gillies K,MacLennan S

    更新日期:2014-09-23 00:00:00

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    abstract:BACKGROUND:Buprenorphine has been reported as an alternative to methadone for maintenance treatment of opioid dependence, but differing results are reported concerning its relative effectiveness indicating the need for an integrative review. OBJECTIVES:To evaluate the effects of buprenorphine maintenance against place...

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    authors: Mattick RP,Kimber J,Breen C,Davoli M

    更新日期:2008-04-16 00:00:00

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    abstract:BACKGROUND:Engorgement is the overfilling of breasts with milk, often occurring in the early days postpartum. It results in swollen, hard, painful breasts and may lead to premature cessation of breastfeeding, decreased milk production, cracked nipples and mastitis. Various treatments have been studied but little consis...

    journal_title:The Cochrane database of systematic reviews

    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


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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Blessberger H,Kammler J,Domanovits H,Schlager O,Wildner B,Azar D,Schillinger M,Wiesbauer F,Steinwender C

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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


    authors: McArthur G,Eve PM,Jones K,Banales E,Kohnen S,Anandakumar T,Larsen L,Marinus E,Wang HC,Castles A

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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Gillespie WJ,Walenkamp GH

    更新日期:2010-03-17 00:00:00

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    abstract:BACKGROUND:Febrile seizures can be classified as simple or complex. Complex febrile seizures are associated with fever that lasts longer than 15 minutes, occur more than once within 24 hours and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograp...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Shah PB,James S,Elayaraja S

    更新日期:2014-01-24 00:00:00

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    abstract:BACKGROUND:Cystic Fibrosis is characterised by chest infection, the antibiotic treatment of which has significantly improved the outlook for people with this condition. The unusual nature of organisms that infect the chest of individuals with cystic fibrosis has restricted antibiotic choice. In particular the bacteria,...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Southern KW,Barker PM,Solis A

    更新日期:2000-01-01 00:00:00

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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Plotnick LH,Ducharme FM

    更新日期:2000-01-01 00:00:00

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    abstract:BACKGROUND:Operative techniques commonly used for fissure in ano include: anal stretch, open lateral sphincterotomy, closed lateral sphincterotomy, posterior midline sphincterotomy and to a lesser extent dermal flap coverage of the fissure. Reports of direct comparisons between operative techniques for anal fissure are...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Nelson R

    更新日期:2005-04-18 00:00:00

  • Hypertonic saline for peri-operative fluid management.

    abstract:BACKGROUND:Fluid excess may place patients undergoing surgery at risk for various complications. Hypertonic saline (HS) maintains intravascular volume with less intravenous fluid than isotonic salt (IS) solutions, but may increase serum sodium. OBJECTIVES:To determine the benefits and harms of HS versus IS solutions a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: McAlister V,Burns KE,Znajda T,Church B

    更新日期:2010-01-20 00:00:00

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    abstract:BACKGROUND:Although people with haematological malignancies have to endure long phases of therapy and immobility, which is known to diminish their physical performance level, the advice to rest and avoid intensive exercises is still common practice. This recommendation is partly due to the severe anaemia and thrombocyt...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Knips L,Bergenthal N,Streckmann F,Monsef I,Elter T,Skoetz N

    更新日期:2019-01-31 00:00:00

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    abstract:BACKGROUND:Hepatocellular carcinoma (HCC) is one of the most common malignant diseases worldwide. The only possibly curative therapeutic option is surgical resection. Due to impaired liver function and/or anatomical reasons only a low percentage of patients can be treated surgically. For the remainder, several non-surg...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Galandi D,Antes G

    更新日期:2002-01-01 00:00:00

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    abstract:BACKGROUND:Tardive dyskinesia is a disabling movement disorder associated with the prolonged use of neuroleptic medication. This review, one in a series examining the treatment of tardive dyskinesia, will cover miscellaneous treatments not covered elsewhere. OBJECTIVES:To determine whether the following interventions ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Soares-Weiser KV,Joy C

    更新日期:2003-01-01 00:00:00