Article ; Online: Efficacy and safety of fluticasone propionate/salmeterol and fluticasone propionate monotherapy in step-up treatment of childhood asthma: A systematic review and meta-analysis.
Heart & lung : the journal of critical care
2023 Volume 63, Page(s) 23–34
Abstract: Background: Asthma is a chronic respiratory disease that affects millions of children worldwide and can impair their quality of life and development. Inhaled glucocorticoids are the mainstay of asthma treatment, but some children require step-up therapy ...
| Abstract | Background: Asthma is a chronic respiratory disease that affects millions of children worldwide and can impair their quality of life and development. Inhaled glucocorticoids are the mainstay of asthma treatment, but some children require step-up therapy with additional drugs to achieve symptom control. Fluticasone propionate and salmeterol (FSC) has been shown to reduce asthma exacerbations and improve lung function in adults. However, the evidence for its efficacy and safety in children is limited. Objective: This study aims to provide a comprehensive basis for treatment selection by summarizing existing clinical randomized controlled trials (RCTs) on the efficacy of FSC compared to fluticasone propionate (FP) monotherapy in children with asthma who require step-up treatment. Methods: Five online databases and three clinical trial registration platforms were systematically searched. The effect size and corresponding 95% confidence interval (CI) were calculated based on the heterogeneity among the included studies. Results: Twelve RCTs were identified and a total of 9, 859 patients were involved. The results of the meta-analysis revealed that the use of FSC was associated with a greater reduction in the incidence of asthma exacerbations than FP alone when the dose of FP was the same or when the duration of treatment exceeded 12 weeks. In addition, FSC resulted in a greater proportion of time with asthma-free and without the use of albuterol compared to FP alone when the duration of treatment exceeded 12 weeks. No significant differences were observed between FSC and FP alone in the incidence of drug-related adverse events and other adverse events. Conclusion: Both FSC and FP alone are viable options for the initial selection of step-up treatment in asthmatic children. While, FSC treatment demonstrates a greater likelihood of reducing asthma exacerbations which is particularly important for reducing the personnel, social and economic burden in children requiring step-up asthma treatment. |
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| MeSH term(s) | Adult ; Child ; Humans ; Fluticasone/therapeutic use ; Fluticasone-Salmeterol Drug Combination/therapeutic use ; Androstadienes/adverse effects ; Asthma/drug therapy ; Albuterol/adverse effects ; Salmeterol Xinafoate/therapeutic use ; Treatment Outcome ; Bronchodilator Agents/adverse effects ; Administration, Inhalation ; Randomized Controlled Trials as Topic |
| Chemical Substances | Fluticasone (CUT2W21N7U) ; Fluticasone-Salmeterol Drug Combination ; Androstadienes ; Albuterol (QF8SVZ843E) ; Salmeterol Xinafoate (6EW8Q962A5) ; Bronchodilator Agents |
| Language | English |
| Publishing date | 2023-09-21 |
| Publishing country | United States |
| Document type | Meta-Analysis ; Systematic Review ; Journal Article ; Review |
| ZDB-ID | 193129-5 |
| ISSN | 1527-3288 ; 0147-9563 |
| ISSN (online) | 1527-3288 |
| ISSN | 0147-9563 |
| DOI | 10.1016/j.hrtlng.2023.09.004 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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