1. Efficacy and safety of different inhaled corticosteroids for bronchopulmonary dysplasia prevention in preterm infants: A systematic review and meta-analysis.
- Author
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Zhang M, Zhang W, and Liao H
- Subjects
- Humans, Administration, Inhalation, Infant, Newborn, Treatment Outcome, Adrenal Cortex Hormones administration & dosage, Adrenal Cortex Hormones adverse effects, Adrenal Cortex Hormones therapeutic use, Randomized Controlled Trials as Topic, Ductus Arteriosus, Patent drug therapy, Ductus Arteriosus, Patent prevention & control, Female, Male, Pulmonary Surfactants administration & dosage, Bronchopulmonary Dysplasia prevention & control, Bronchopulmonary Dysplasia epidemiology, Infant, Premature, Budesonide administration & dosage, Budesonide therapeutic use, Beclomethasone administration & dosage, Fluticasone administration & dosage, Fluticasone therapeutic use
- Abstract
Background: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of inhaled corticosteroids (budesonide, beclomethasone, or fluticasone propionate) in preventing bronchopulmonary dysplasia (BPD) for premature infants., Method: Electronic databases, including PubMed, EMBASE, Web of science, Scopus, and Cochrane library, were searched from databases inception to January 2022 for eligible randomized controlled trials. Clinical outcomes such as BPD, mortality, BPD or death, adverse events, and neurodevelopmental outcomes were assessed., Results: Overall, budesonide was significantly associated with a reduction in BPD at 36 weeks' postmenstrual age (RR 0.48; 95 % CI [0.38, 0.62]) and patent ductus arteriosus (PDA) (RR 0.75; 95 % CI [0.63, 0.89]) compared with control treatments. Early longer duration inhalation of budesonide alone was associated with a lower risk of BPD at 36 weeks' postmenstrual age and PDA compared with controls. Early shorter duration intratracheal instillation of budesonide with surfactant as vehicle was associated with a lower risk of BPD at 36 weeks' postmenstrual age and all-cause mortality compared with surfactant. There was no statistically significant difference between budesonide and control groups regarding neurodevelopmental impairment. Beclomethasone and fluticasone propionate did not show any superior or inferior effect on clinical outcomes compared to control treatments., Conclusion: These findings suggest that budesonide, especially intratracheal instillation of budesonide using surfactant as a vehicle, is a safe and effective option in preventing BPD for preterm infants. More well-design large-scale trials with long-term follow-ups are necessary to verify the present findings., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2024 SPLF and Elsevier Masson SAS. All rights reserved.)
- Published
- 2024
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