Efficacy of angiotensin receptor blocker combined with glucocorticoid in idiopathic pulmonary fibrosis: A meta-analysis
10.13699/j.cnki.1001-6821.2017.21.025
- VernacularTitle:血管紧张素抑制药联合糖皮质激素对特发性肺纤维化作用的系统评价
- Author:
Zhi-Chao WANG
1
;
Qi WU
;
Fan-Chao FENG
;
Hai-Lang HE
;
Xian-Mei ZHOU
Author Information
1. 南京中医药大学附属医院、江苏省中医院呼吸科
- Keywords:
angiotensin receptor blocker;
glucocorticoid;
idiopathic pulmonary fibrosis;
randomized controlled trial
- From:
The Chinese Journal of Clinical Pharmacology
2017;33(21):2182-2186
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically review the efficacy of angiotensin receptor blocker (ARB) combined with glucocorticoid for patients with idiopathic pulmonary fibrosis (IPF).Methods Electronically searched PubMed,EmBase,the Cochrane Library,CNKI,CBM,VIP,Wanfang Database from the date of establishment to March 2017 for all randomized controlled trials (RCTs) and quasi-RCTs based on ARB combined with glucocorticoid therapy for patients with IPF.Manual search in relevant journals and search of relevant literature on other websites were also performed.The data extraction and quality assessment of included RCTs and quasi-RCTs were conducted by two reviewers independently.Then,Meta-analysis was conducted by using RevMan 5.3 software.Results A total of 12 RCTs involving 1239 patients were included,621 cases in treatment group and 618 cases in control group.The results of Meta-analysis indicated that the treatment group was superior to the control group in clinical effectiveness (OR =2.78,95％ CI:2.12-3.66,P ＜ O.001),partial pressure of oxygen (PaO2,MD =8.76,95％ CI:7.26-10.26,P ＜0.001),partial pressure of carbon dioxide (PaCO2,MD =-14.04,95％ CI:-15.03--13.05,P ＜0.001),forced vital capacity (FVC,MD =0.74,95％ CI:O.55-0.94,P ＜0.001),forced expiratory volume in one second (FEV1,MD =0.74,95％ CI:0.63-0.86,P ＜0.001),diffusion capacity for carbon monoxide (DLCO) value (MD =3.70,95％ CI:1.88-5.51,P ＜ 0.001) and vital capacity (VC,MD=5.23,95％ CI:3.38-7.08,P＜O.001).Conclusion The current evidence suggested that ARB combined with glucocorticoid could increase clinical effectiveness,improve PaO2,FVC,FEV1,DLCO and VC,and decrease PaCO2 in serum of IPF patients.
