Browsing by Author "Rodrigo, Gustavo J."

Now showing 1 - 7 of 7
  • Thumbnail Image
    Item
    A systematic review of long-acting β2-agonists versus higher doses of inhaled corticosteroids in asthma
    (2012) Castro Rodríguez, José Antonio; Rodrigo, Gustavo J.
    OBJECTIVE: To compare the efficacy of inhaled corticosteroids (ICS) plus long-acting β2 agonist (LABA) versus higher doses of ICS in children/adolescents with uncontrolled persistent asthma. METHODS: Randomized, prospective, controlled trials published January 1996 to January 2012 with a minimum of 4 weeks of LABA+ICS versus higher doses of ICS were retrieved through Medline, Embase, Central, and manufacturer’s databases. The primary outcome was asthma exacerbations requiring systemic corticosteroids; secondary outcomes were the pulmonary function test (PEF), withdrawals during the treatment period, days without symptoms, use of rescue medication, and adverse events. RESULTS: Nine studies (n = 1641 patients) met criteria for inclusion (7 compared LABA+ICS versus double ICS doses and 2 LABA+ICS versus higher than double ICS doses). There was no statistically significant difference in the number of patients with asthma exacerbations requiring systemic corticosteroids between children receiving LABA+ICS and those receiving higher doses of ICS (odds ratio = 0.76; 95% confidence interval: 0.48–1.22, P = .25, I2 = 16%). In the subgroup analysis, patients receiving LABA+ICS showed a decreased risk of asthma exacerbations compared with higher than twice ICS doses (odds ratio = 0.48; 95% confidence interval: 0.28–0.82, P = .007, I2= 0). Children treated with LABA+ICS had significantly higher PEF, less use of rescue medication, and higher short-term growth than those on higher ICS doses. There were no other significant differences in adverse events. CONCLUSIONS: There were no statistically significant group differences between ICS+LABA and double doses of ICS in reducing the incidence of asthma exacerbations but it did decrease the risk comparing to higher than double doses of ICS.
  • Thumbnail Image
    Item
    Comparison of three combined pharmacological approaches with tiotropium monotherapy in stable moderate to severe COPD: A systematic review
    (2012) Rodrigo, Gustavo J.; Plaza, Vicente; Castro Rodríguez, José Antonio
    Background: Guidelines recommend the use of inhaled long-acting bronchodilators, inhaled corticosteroids (ICS) and their combinations for maintenance treatment of moderate to severe COPD. However, there are limited data supporting combination therapy. Methods: This systematic review assessed the efficacy of three therapeutic approaches: tiotropium plus long-acting beta2-agonist (LABA) (“dual” therapy), LABA/ICS (“combined” therapy), and tiotropium plus LABA/ICS (“triple” therapy), all compared with tiotropium monotherapy. Randomized controlled trials were identified after a search of different databases of published and unpublished trials. Results: Twenty trials (6803 participants) were included. “Dual” therapy showed significant improvements in forced volume in the first second (FEV1), health-related quality of life (HRQoL), and dyspnea. However, it failed to reduce the risk of COPD exacerbations. Compared with tiotropium, “combined” therapy presented modest but significant effects on FEV1, HRQoL, and dyspnea. Again, there was no significant difference in exacerbations, but it was associated with a significant increase of serious adverse effects (SAE) (number need to treat for harm [NNTH] ¼ 20; 95% CI: 11e119). Finally, “triple therapy” increased FEV1, improved HRQoL (both benefits exceeded minimal important differences) and decrease COPD exacerbations in anon-significant way. (Odds ratio [OR] ¼ 0.57; 95% CI: 0.24 to 1.37, p ¼ 0.21). Conclusions: “Dual” and “triple” therapy seem like the most promising for patients with moderate to very severe COPD. However, data are still scarce and studies too short to generate a strong recommendation. Future studies should examine long-term efficacy and safety.
  • Thumbnail Image
    Item
    Efficacy of inhaled corticosteroids in wheezy infants/preschoolers
    (2013) Castro Rodríguez, José Antonio; Rodrigo, Gustavo J.
  • Thumbnail Image
    Item
    Principal findings of systematic reviews for chronic treatment in childhood asthma
    (2015) Castro Rodríguez, José Antonio; Rodrigo, Gustavo J.; Rodríguez Martínez, Carlos E.
  • Thumbnail Image
    Item
    Principal findings of systematic reviews of acute asthma treatment in childhood
    (2015) Castro Rodríguez, José Antonio; Rodrigo, Gustavo J.; Rodríguez Martínez, Carlos E.
  • Thumbnail Image
    Item
    Response
    (2015) Rodrigo, Gustavo J.; Castro Rodríguez, José Antonio
  • Thumbnail Image
    Item
    What Is the Role of Tiotropium in Asthma? : A Systematic Review With Meta-analysis
    (2015) Rodrigo, Gustavo J.; Castro Rodríguez, José Antonio