Intervention Review

Tartrazine exclusion for allergic asthma

  1. Kate Ardern2,
  2. Felix SF Ram3

Editorial Group: Cochrane Airways Group

Published Online: 7 OCT 2009

Assessed as up-to-date: 31 JAN 2006

DOI: 10.1002/14651858.CD000460

Database Title

Additional Information

How to Cite

Ardern K, Ram FSF. Tartrazine exclusion for allergic asthma. Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD000460. DOI: 10.1002/14651858.CD000460.

Author Information

  1. 2

    Liverpool Health Authority, Department of Public Health, Liverpool, UK

  2. 3

    Massey University - Auckland, School of Health Sciences, Auckland, New Zealand

*Toby J Lasserson, Community Health Sciences, St George's, University of London, Cranmer Terrace, Tooting, London, SW17 ORE, UK. tlassers@sgul.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 7 OCT 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Tartrazine is the best known and one of the most commonly used food additives. Food colorants are also used in many medications as well as foods. There has been conflicting evidence as to whether tartrazine causes exacerbations of asthma with some studies finding a positive association especially in individuals with cross-sensitivity to aspirin.

Objectives

To assess the overall effect of tartrazine (exclusion or challenge) in the management of asthma.

Search methods

A search was carried out on the Cochrane Airways Group Specialised Register. Bibliographies of each RCT was searched for additional papers. Authors of identified RCTs were contacted for further information. Searches are updated annually and are current as of February 2006.

Selection criteria

RCTs of oral administration of tartrazine (as a challenge) versus placebo or dietary avoidance of tartrazine versus normal diet were considered. Studies which focused upon allergic asthma, were also included. Studies of tartrazine exclusion for other allergic conditions such as hay fever, allergic rhinitis and eczema were only considered if the results for subjects with asthma were separately identified. Trials could be in either adults or children with asthma or allergic asthma (e.g. sensitivity to aspirin or food items known to contain tartrazine).

Data collection and analysis

Study quality was assessed and data abstracted by two reviewers independently. Outcomes were analysed using RevMan 4.1.1.

Main results

Ninety abstracts were found, of which 18 were potentially relevant. Six met the inclusion criteria, but only three presented results in a format that permitted analysis and none could be combined in a meta-analysis. In none of the studies did tartrazine challenge or avoidance in diet significantly alter asthma outcomes.

Authors' conclusions

Due to the paucity of available evidence, it is not possible to provide firm conclusions as to the effects of tartrazine on asthma control. However, the six RCTs that could be included in this review all arrived at the same conclusion. Routine tartrazine exclusion may not benefit most patients, except those very few individuals with proven sensitivity.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Tartrazine exclusion for allergic asthma

Tartrazine is the best known and one of the most commonly used food additives. Food colorants are also used in many medications as well as foods. There is no evidence that tartrazine makes asthma worse or avoiding it makes asthma patients any better.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

Penicillamine 治療類風濕性關節炎

Penicillamine是penicillin衍生物製劑，雖然於1950年代常用於治療類風濕性關節炎，但其它修飾病程抗風濕藥物(DMARD)如Methotrexate增加使用後，其使用量已減少

目標

評估Penicillamine在治療類風濕性關節炎的短期效果

搜尋策略

搜尋包括Cochrane Musculoskeletal Group's trials register, Cochrane Controlled Trials Register (issue 3, 2000) and MEDLINE (直到2000年8月)及EMBASE 1988 – 2000。同時手動搜尋所選文章之參考文獻

選擇標準

所有比較Penicillamine與安慰劑於類風濕性關節炎病人之隨機對照及控制對照臨床研究

資料收集與分析

每篇試驗研究的品質由兩位作者使用經效度驗證過之品質評估工具﹝Jadad 1996﹞獨立評估，並由第三位作者驗證。。類風濕性關節炎病人之結果測量為6個月終點指標，並依Dpenicillamine使用的劑量: 低 (小於500 毫克/天)，中 (500 到1000毫克/天) ，及高劑量 (大於或等於1000毫克/天)做分層分析。一位作者擷取數據，並由另一位作者檢查。以標準化加權平均差異(standardized mean difference)做腫脹的關節數，疼痛及總體評估。紅血球沈降速率以加權平均差異做評估。毒性則以退出治療及副作用之勝算比為評估指標。本文使用卡方檢定看各試驗間的異質性，因無統計上異質性，因此以固定效應模型(fixedeffects model)分析

主要結論

6個研究包含於分析中，425例病患使用Penicillamine藥物，258例病患使用安慰劑。DPenicillamine藥物三種劑量比安慰劑療效在多種指標包括腫脹的關節數，疼痛及醫師總體評估及紅血球沈降速率上有統計上顯著差異。 在中劑量 (500 到1000毫克/天)與安慰劑，腫脹的關節數標準化平均差異是 −0.51 (介於 −0.88 to −0.14)之間，疼痛標準化平均差異是 −0.56 (介於 −0.87 to −0.26)之間，在醫師總體評估是 −0.97 (介於 −1.25 to −0.70)。紅血球沉降速率差異是 −10.6 mm/hr。高劑量組也有相似結果。副作用在高劑量及中劑量Dpenicillamine組較高 (OR分別為1.63 及 2.13)，主要是腎臟及血液的副作用反應增加 (OR分別為2.60 及 4.95)

作者結論

Penicillamine治療類風濕性關節炎疾病活性有臨床及統計上顯著差異。其效果與其它修飾病程抗風濕藥物(DMARD)相似，但Penicillamine副作用較多。Penicillamine長期效果在功能性狀況及影像進展惡化並不清楚

翻譯人

本摘要由林口長庚醫院余光輝翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

1950年代DPenicillamine開始用於治療類風濕性關節炎，但其它修飾病程抗風濕藥物(DMARD)如Methotrexate增加使用後，其使用量已減少。Dpenicillamine在各種劑量範圍組似乎有效，包括關節疼痛及醫師總體評估及紅血球沈降速率上有統計上顯著差異。低劑量(小於500毫克/天) 與安慰劑組無顯著差異， 高劑量組Dpenicillamine 比安慰劑組退出使用高2倍。Dpenicillamine治療類風濕性關節炎疾病活性有臨床及統計上顯著差異。其效果與其它修飾病程抗風濕藥物(DMARD)相似，但使用Penicillamine時副作用較多

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