Intervention Review

Troleandomycin as an oral corticosteroid sparing agent in stable asthma

  1. David J Evans1,*,
  2. Paul Cullinan2,
  3. Duncan M Geddes3,
  4. E. Haydn Walters4,
  5. Stephen J Milan5,
  6. Paul Jones6

Editorial Group: Cochrane Airways Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 2 SEP 2010

DOI: 10.1002/14651858.CD002987

Database Title

Additional Information

How to Cite

Evans DJ, Cullinan P, Geddes DM, Walters EH, Milan SJ, Jones P. Troleandomycin as an oral corticosteroid sparing agent in stable asthma. Cochrane Database of Systematic Reviews 2000, Issue 4. Art. No.: CD002987. DOI: 10.1002/14651858.CD002987.

Author Information

  1. 1

    Hemel Hempstead Hospital, Thoracic Medicine, Hemel Hempstead, Herts, UK

  2. 2

    Imperial College (NHLI), Department of Occupational and Environmental Medicine, London, UK

  3. 3

    Royal Brompton Hospital, Respiratory Medicine, London, UK

  4. 4

    University of Tasmania, Menzies Research Institute, Hobart, Tasmania, Australia

  5. 5

    St George's Healthcare NHS Trust, Clinical Effectiveness Department, London, UK

  6. 6

    St George's Hospital Medical School, Cardiovascular Medicine, London, UK

*David J Evans, Thoracic Medicine, Hemel Hempstead Hospital, Hillfield Road, Hemel Hempstead, Herts, HP2 4AD, UK. david.evans@whht.nhs.uk. D.Evans@rbh.nthames.nhs.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 21 JAN 2009

SEARCH

ARTICLE TOOLS

View Full Article (HTML) Summary (56K)Standard (190K)Full (211K)
 

Abstract

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

Background

Patients with chronic severe asthma are often dependent on the long term prescription of oral corticosteroids. The use of steroids is associated with serious side effects. Physicians treating such patients continue to search for alternative therapies that reduce the need for chronic dosing with oral steroids. Troleandomycin is a compound that is established as an effective antibiotic but may also have non-antibacterial actions that may be useful in the treatment of asthma.

Objectives

The objective of this review was to assess the effects of adding troleandomycin to oral steroids in the treatment of chronic steroid dependent asthmatics.

Search methods

The Cochrane Airways Group Specialised Register and reference lists of identified articles were searched. Searches are current as of September 2010.

Selection criteria

Randomised trials looking at the addition of troleandomycin compared to placebo in adult steroid dependent asthmatics.

Data collection and analysis

Trial quality was assessed and data extraction was carried out by two reviewers independently. Study authors were contacted for missing information.

Main results

Three trials fulfilled the criteria for inclusion in the review and a total of 112 patients were recruited into these studies. Data from 90 patients were analysed. There was no treatment effect for troleandomycin in terms of steroid dose reduction (SMD -0.29, 95% CI -0.75, 0.17). For measures of lung function a meta-analysis of data derived from two of the included studies showed no benefits for added troleandomycin (SMD 0.06 95% CI -0.8, 0.9).

Authors' conclusions

There is insufficient evidence to support the use of troleandomycin in the treatment of steroid dependent asthma.

 

Plain language summary

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

Troleandomycin as an oral corticosteroid sparing agent in stable asthma

Troleandomycin is a macrolide antibiotic with established effects in the treatment of infections. It alters the breakdown of corticosteroid drugs, so may be of benefit in asthma. This review found three small studies, that provide no evidence to justify the use of this drug in asthma.

 

摘要

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

背景

對穩定氣喘患者使用troleandomycin作為皮質類固醇節約劑(sparing agent)

嚴重的慢性氣喘患者通常需要長期仰賴口服皮質類固醇。但是，類固醇的使用可能造成嚴重的副作用。治療這類病患的醫師不斷地在尋找其它替代治療，期望可以劑降低長期口服類固醇的需求。Troleandomycin是一種化合物，已經確定為一種有效的抗生素，但它也有非抗菌作用，在氣喘治療方面可能有用。

目標

本回顧旨在評估：治療慢性類固醇依賴的氣喘患者時，在口服類固醇外添加troleandomycin的影響。

搜尋策略

搜尋Cochrane Airways Group Specialised Register of Trials和找到的文章的參考資料清單。目前搜尋到2007年9月。

選擇標準

針對類固醇依賴的氣喘成年患者，比較添加troleandomycin和安慰劑的隨機試驗。

資料收集與分析

兩位審查員各自評估試驗品質，並擷取數據。不足的資料則連絡研究作者。

主要結論

三個試驗符合本回顧的納入條件，共112位病患。分析90位病患的數據。在減少類固醇用藥劑量方面，troleandomycin並沒有治療效果(SMD 0.29，95%信賴區間0.75，0.17)。在肺功能測量值方面，兩篇納入研究的數據經統合分析後顯示：添加troleandomycin沒有效益(SMD 0.06，95%信賴區間0.8，0.9)。

作者結論

沒有充分證據支持troleandomycin用來 治療類固醇依賴性氣喘。

翻譯人

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

總結

Troleandomycin是一種大環類(macrolide)抗生素，在治療感染症方面已有確定性的效果。它改變皮質類固醇藥物的分解，可能對氣喘有所幫助。本回顧發現三個小型研究，結果無法提供任何證據－證明此藥在氣喘患者的療效。

View Full Article (HTML) Summary (56K)Standard (190K)Full (211K)