Objective To systematically evaluate the effectiveness and safety of macrolides in the prevention of COPD exacerbation.
Methods The literatures concerning both randomized controlled trials ( RCTs ) and clinical control study of COPD were searched in PUBMED, EMBASE, Chinese National Knowledge Infrastructure ( CNKI) ,Wanfang, and Chinese Science and Technology Journal Full-text Database ( VIP) ( last updated in September 2012) . The quality assessment and data extraction for RCTs were conducted by two reviewers independently.Meta-analyses were conducted with the Cochrane Collaboration’s RevMan 4. 2 software.
Results In all trials, the results indicated that the frequency of acute exacerbation in the macrolide treatment group was decreased compared with the control group [ RR= 0. 63, 95% CI( 0. 50, 0. 79) ] . The frequency of acute exacerbation treated with macrolides was significantly decreased in Asians [ RR= 0. 58, 95% CI ( 0. 44, 0. 75) ] but not in Caucasians [ RR = 0. 79, 95% CI ( 0. 47, 1. 31) ] . The frequency of acute exacerbation treated with roxithromycin was significantly decreased compared with the control group [ RR=0. 54,95% CI( 0. 32, 0. 91) ] . In addition, the macrolides treatment had no side effects except for a few and mild gastrointestinal adverse effects.
Conclusion Macrolides may be an effective drug to prevent COPD exacerbation.
Citation： HE Jie,YANG Jiqiao,TONG Xiang,FU Xiaowei,LI Xiaoyan,FAN Hong. Effectiveness and Safety of Macrolides in Prevention of COPD Exacerbation: A Meta-analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2013, 12(1): 12-18. doi: 10.7507 /1671 -6205.20130004 Copy