囊性纤维化Dornase阿尔法。
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琼斯美联社,沃利斯C
囊性纤维化Dornase阿尔法。
科克伦数据库系统启2010年3月17日;(3):CD001127。cd001127.pub2 doi: 10.1002/14651858.。
- PubMed ID
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20238314 (在PubMed]
- 文摘
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背景:Dornase阿尔法目前用于治疗肺部疾病发病率和死亡率的主要原因在囊性纤维化。目的:确定是否使用dornase阿尔法在囊性纤维化与改善死亡率和发病率相比安慰剂或其他黏液溶解的和识别和其使用相关联的任何不良事件。搜索策略:我们搜查了Cochrane囊性纤维化和遗传疾病组试验注册包括引用识别从综合电子数据库搜索,handsearching相关的期刊和会议摘要。日期最近的搜索集团囊性纤维化的注册:2009年7月17日。选择标准:所有随机和quasi-randomised对照试验,dornase阿尔法与安慰剂相比,标准治疗或另一种黏液溶解的。数据收集和分析:作者独立评估试验入选标准;第一作者和同事进行分析的方法学质量和数据提取。主要结果:搜索发现43试验,其中15满足我们的入选标准,包括共有2469名参与者。三个额外的研究检查了医疗成本的临床试验。12个研究相比dornase阿尔法安慰剂或没有dornase阿尔法治疗;相比一个每日dornase阿尔法和食盐水和候补天dornase阿尔法; and two compared daily dornase alfa to hypertonic saline. Study duration varied from six days to two years. The number of deaths was not significant between treatment groups. Spirometric lung function improved in the treated groups, with significant differences at one month, three months, six months and two years, there was a non-significant difference at three years. There was no excess of adverse effects except voice alteration and rash, which were reported more frequently in one trial in the treated groups. Insufficient data were available to analyse differences in antibiotic treatment, inpatient stay and quality of life. AUTHORS' CONCLUSIONS: There is evidence to show that therapy with dornase alfa over a one-month period is associated with an improvement in lung function in CF; results from a trial lasting six months also showed the same effect. Therapy over a two-year period (based on one trial) significantly improved FEV(1) in children and there was a non-significant reduction in the risk of infective exacerbations. Voice alteration and rash appear to be the only adverse events reported with increased frequency in randomised controlled trials.
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