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Minerva Pediatrics 2021 May 14

DOI: 10.23736/S2724-5276.21.05939-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Comparison of the effect of fluticasone combined with salmeterol and fluticasone alone in the treatment of pediatric asthma: review and meta-analysis

Huling CAO 1, Junhua GU 2, Juan DAI 1, Guihong YANG 1, Hui TANG 1, Aiming DING 3

1 Pediatric Ward, the Second Affiliated Hospital of Nantong University, Nantong City, China; 2 Department of Radioiogy, the Second Affiliated Hospital of Nantong University, Nantong City, China; 3 Department of Nursing, the Second Affiliated Hospital of Nantong University, Nantong City, China


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BACKGROUND: A systematic review and meta-analysis was performed to investigate the effect of fluticasone + salmeterol and fluticasone alone in the treatment of pediatric asthma.
METHODS: Studies meeting specific selection criteria were selected from online databases, including Pubmed, Embase, and the Cochrane Library. The quality of randomized controlled trials was assessed using the Cochrane Library. Weighted mean difference (WMD) and 95% CI were used to evaluate the effect size of continuous variables, while rate ratio (RR) and 95% CI were used for dichotomous variables.
RESULTS: A total of 11 studies, including 8,272 pediatric asthma patients, were included in this meta-analysis. Among these, 4,133 patients were in the salmeterol + fluticasone group. The changes in forced expiratory volume in 1 second in children with asthma in the salmeterol + fluticasone and fluticasone alone groups were significantly different (fixed effects model, WMD = 3.26, 95% CI: 1.52-5.00, P = 0.0002). Asthma exacerbation between two groups were significantly different (fixed effects model, RR = 0.85, 95% CI: 0.73-0.98, Z = 2.18, P = 0.03). There was no difference in the incidence of adverse events between salmeterol + fluticasone and fluticasone alone in the treatment of pediatric asthma (P > 0.05). When the control group was treated with double dose fluticasone, the difference of changes in FEV1 and asthma exacerbation in children with asthma between the two groups were not significant.
CONCLUSIONS: The efficacy of salmeterol + fluticasone is better than fluticasone alone, and the efficacy of salmeterol + fluticasone is equal to doubling the dose of fluticasone in the treatment of pediatric asthma.


KEY WORDS: Adverse events; Fluticasone; Salmeterol combined with fluticasone; Meta-analysis; Pediatric asthma

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