Efficacy and safety of different inhaled corticosteroids for bronchopulmonary dysplasia prevention in preterm infants: A systematic review and meta-analysis

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. Electronic databases, including PubMed, EMBASE, Web of science,...

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Veröffentlicht in:Respiratory medicine and research 2024-06, Vol.85, p.101096, Article 101096
Hauptverfasser: Zhang, Minghai, Zhang, Wei, Liao, Hongqun
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Zhang, Wei
Liao, Hongqun
description 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. 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. 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. 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.
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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. 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. 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control</topic><topic>Female</topic><topic>Fluticasone</topic><topic>Fluticasone - administration &amp; dosage</topic><topic>Fluticasone - therapeutic use</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Male</topic><topic>Premature infant</topic><topic>Pulmonary Surfactants - administration &amp; dosage</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Minghai</creatorcontrib><creatorcontrib>Zhang, Wei</creatorcontrib><creatorcontrib>Liao, Hongqun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine and research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Minghai</au><au>Zhang, Wei</au><au>Liao, Hongqun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of different inhaled corticosteroids for bronchopulmonary dysplasia prevention in preterm infants: A systematic review and meta-analysis</atitle><jtitle>Respiratory medicine and research</jtitle><addtitle>Respir Med Res</addtitle><date>2024-06</date><risdate>2024</risdate><volume>85</volume><spage>101096</spage><pages>101096-</pages><artnum>101096</artnum><issn>2590-0412</issn><eissn>2590-0412</eissn><abstract>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. 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subjects Administration, Inhalation
Adrenal Cortex Hormones - administration & dosage
Adrenal Cortex Hormones - adverse effects
Adrenal Cortex Hormones - therapeutic use
Beclomethasone
Beclomethasone - administration & dosage
Bronchopulmonary dysplasia
Bronchopulmonary Dysplasia - epidemiology
Bronchopulmonary Dysplasia - prevention & control
Budesonide
Budesonide - administration & dosage
Budesonide - therapeutic use
Ductus Arteriosus, Patent - drug therapy
Ductus Arteriosus, Patent - prevention & control
Female
Fluticasone
Fluticasone - administration & dosage
Fluticasone - therapeutic use
Humans
Infant, Newborn
Infant, Premature
Male
Premature infant
Pulmonary Surfactants - administration & dosage
Randomized Controlled Trials as Topic
Treatment Outcome
title Efficacy and safety of different inhaled corticosteroids for bronchopulmonary dysplasia prevention in preterm infants: A systematic review and meta-analysis
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