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Inhaled corticosteroids improve lung function, airway hyper‑responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta‑analysis

  • Authors:
    • Wei Du
    • Ling Zhou
    • Yingmeng Ni
    • Yuanyuan Yu
    • Fang Wu
    • Guochao Shi
  • View Affiliations / Copyright

    Affiliations: Department of Pulmonary Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China, Department of Geratology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
    Copyright: © Du et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 1594-1608
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    Published online on: June 27, 2017
       https://doi.org/10.3892/etm.2017.4694
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Abstract

It remains controversial whether inhaled corticosteroid (ICS) should be used in patients with intermittent asthma. The present study aimed to assess the effect of ICS compared with placebo or other therapies in patients with intermittent asthma. Medline, Embase and CNKI databases were searched up to June 2016 and a meta‑analysis was conducted. The findings demonstrated that in adult patients, when compared with placebo, ICS increased forced expiratory volume in 1 sec FEV1 [standardized mean difference (SMD), 0.51; 95% confidence interval (CI), 0.22‑0.80] and alleviated airway hyper‑responsiveness, which was indicated as log transformed PC20FEV1 (concentrations of methacholine when there was a fall in FEV1 ≥20%; SMD, 0.87; 95% CI, 0.60 to 1.14). ICS also reduced fractional exhaled nitric oxide (FeNO) levels [weighted mean difference (WMD), ‑12.57 parts per billion (ppb; a unit of NO concentration in exhaled air); 95% CI ‑15.88 to ‑9.25 ppb]. However, symptom scores did not change after ICS treatment (SMD, ‑0.26; 95% CI, ‑0.52 to 0). When compared with leukotriene receptor antagonists (LTRA), ICS had no advantage in increasing FEV1 (WMD, 0.04 l; 95% CI, ‑0.06 to 0.13 l), reducing sputum eosinophil percentage (WMD, ‑6%; 95% CI, ‑12.38 to 0.38%) or symptom scores (SMD, 0.44; 95% CI, ‑0.02 to 0.9). However, in child patients, ICS significantly (P<0.05) increased the possibility of symptom control when compared with placebo [relative risk (RR), 8; 95% CI, 1.04 to 61.52] or LTRA (RR, 2.67; 95% CI, 0.39 to 18.42). In conclusion, ICS improves lung function and alleviates airway hyper‑responsiveness and airway inflammation but cannot influence symptom scores, and has no advantage over LTRA in terms of lung function improvement and airway inflammation control in adult patients with mild intermittent asthma. However, in children, the benefit of ICS in symptom control is more significant than with LTRA.
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Copy and paste a formatted citation
Spandidos Publications style
Du W, Zhou L, Ni Y, Yu Y, Wu F and Shi G: Inhaled corticosteroids improve lung function, airway hyper‑responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta‑analysis. Exp Ther Med 14: 1594-1608, 2017.
APA
Du, W., Zhou, L., Ni, Y., Yu, Y., Wu, F., & Shi, G. (2017). Inhaled corticosteroids improve lung function, airway hyper‑responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta‑analysis. Experimental and Therapeutic Medicine, 14, 1594-1608. https://doi.org/10.3892/etm.2017.4694
MLA
Du, W., Zhou, L., Ni, Y., Yu, Y., Wu, F., Shi, G."Inhaled corticosteroids improve lung function, airway hyper‑responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta‑analysis". Experimental and Therapeutic Medicine 14.2 (2017): 1594-1608.
Chicago
Du, W., Zhou, L., Ni, Y., Yu, Y., Wu, F., Shi, G."Inhaled corticosteroids improve lung function, airway hyper‑responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta‑analysis". Experimental and Therapeutic Medicine 14, no. 2 (2017): 1594-1608. https://doi.org/10.3892/etm.2017.4694
Copy and paste a formatted citation
x
Spandidos Publications style
Du W, Zhou L, Ni Y, Yu Y, Wu F and Shi G: Inhaled corticosteroids improve lung function, airway hyper‑responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta‑analysis. Exp Ther Med 14: 1594-1608, 2017.
APA
Du, W., Zhou, L., Ni, Y., Yu, Y., Wu, F., & Shi, G. (2017). Inhaled corticosteroids improve lung function, airway hyper‑responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta‑analysis. Experimental and Therapeutic Medicine, 14, 1594-1608. https://doi.org/10.3892/etm.2017.4694
MLA
Du, W., Zhou, L., Ni, Y., Yu, Y., Wu, F., Shi, G."Inhaled corticosteroids improve lung function, airway hyper‑responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta‑analysis". Experimental and Therapeutic Medicine 14.2 (2017): 1594-1608.
Chicago
Du, W., Zhou, L., Ni, Y., Yu, Y., Wu, F., Shi, G."Inhaled corticosteroids improve lung function, airway hyper‑responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta‑analysis". Experimental and Therapeutic Medicine 14, no. 2 (2017): 1594-1608. https://doi.org/10.3892/etm.2017.4694
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