Efficacy and safety of local triamcinolone combined with conventional interventional therapy in treatment of benign airway stenosis: a meta-analysis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

HE Jie ^1,2 , YU Mi ^1,2 , LI Xiaoyan ^1,2 , ZHANG Wei ^1,2 ,  SUN Jian ^1,2

1. Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan 610500, P. R. China;
2. Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500, P. R. China;

Corresponding author：

SUN Jian, Email: 157110097@qq.com

Keywords：

Triamcinolone; Local injection; Local spraying; Benign airway stenosis; Meta-analysis

DOI：

10.7507/1671-6205.201908088

Video：

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Objective To evaluate the efficacy and safety of local triamcinolone combined with conventional interventional therapy in the treatment of benign airway stenosis. Methods PubMed, Cochrane Library, EMbase, Web of science, wanfang, VIP and China National Knowledge Infrastructure were searched by computer between the establishment of the database and August, 2019, and all literatures on the local treatment of benign airway stenosis using triamcinolone combined with conventional interventional therapy were searched. According to inclusion and exclusion criteria, 2 researchers screened the literatures and performed the data extraction and methodological quality evaluation. Meta-analysis was performed with Revman5.2 and Stata software. Results In total, nine randomized controlled trials were included in this meta-analysis, including 449 patients with airway stenosis. The total result showed that in the comparison of short-term efficacy, there were no statistically significant differences in breathability score (SMD=–0.16, 95%CI –0.45 - 0.13, P=0.27), airway diameter (SMD=0.14, 95%CI –0.13 - 0.41, P=0.30), and cross-sectional stenosis rate (SMD=–0.01, 95%CI –0.36 - 0.34, P=0.96) between the treatment group and the control group. In the comparison of long-term efficacy, the breathability score (SMD=–2.53, 95%CI –3.78 - –1.28, P<0.05), airway diameter (SMD=1.31, 95%CI 0.83 - 1.78, P<0.05), cross-sectional stenosis rate (SMD=2.58, 95%CI: 2.11~3.08, P<0.05), and FEV₁(SMD=0.42, 95%CI 0.13 - 0.70, P=0.004) of patients in the treatment group were all better than those in the control group. But in terms of adverse reactions, the incidence of bleeding in the airway between two groups was similar (RR=2.00, 95%CI 0.88 - 4.52, P=0.10), other adverse reactions such as blood glucose and plasma cortisol levels were mild, which can be relieved symptomatically. Conclusion Current evidence suggests that topical triamcinolone combined with conventional interventional therapy for benign airway stenosis has a better long-term clinical efficacy with fewer adverse reactions and better overall patient tolerance, which has clinical application value

Citation： HE Jie, YU Mi, LI Xiaoyan, ZHANG Wei, SUN Jian. Efficacy and safety of local triamcinolone combined with conventional interventional therapy in treatment of benign airway stenosis: a meta-analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(10): 726-733. doi: 10.7507/1671-6205.201908088 Copy

1.	Xiong XF, Xu L, Fan LL, et al. Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study. BMC Pulm Med, 2019, 19(1): 33.
2.	Fortin M, Lacasse Y, Elharrar X, et al. Safety and efficacy of a fully covered self-expandable metallic stent in benign airway stenosis. Respiration, 2017, 93(6): 430-435.
3.	Kniese CM, Musani AI. Interventional pulmonology: a focused review for primary care physicians. Med Clin North Am, 2019, 103(3): 399-412.
4.	Michaud G. Review of recent important papers in interventional pulmonology. Semin Thorac Cardiovasc Surg, 2018, 30(2): 212-214.
5.	Mondoni M, Radovanovic D, Sotgiu G, et al. Interventional pulmonology techniques in elderly patients with comorbidities. Eur J Intern Med, 2019, 59: 14-20.
6.	Khan HA, Sahibzada MN, Paracha MM. Comparison of the efficacy of intralesional bleomycin versus intralesional triamcinolone acetonide in the treatment of keloids. Dermatol Ther, 2019, 32(5): e13036.
7.	陈愉, 伍惠仪, 李时悦, 等. 局部注射曲安奈德结合常规介入方法治疗难治性良性中央气道狭窄疗效及安全性的初步探讨. 中华结核和呼吸杂志, 2012, 35(6): 415-418.
8.	李志东, 陈思宇, 肖谊, 等. 气管镜下介入高压球囊扩张联合局部注射激素治疗气道狭窄的临床研究. 中国药物经济学, 2014, 9(S1): 404-405.
9.	胡鑫, 张会云, 边南南, 等. 第二代ALK抑制剂治疗ALK⁺非小细胞肺癌有效性单组率的Meta分析. 中国循证医学杂志, 2018, 18(9): 918-923.
10.	周子青, 苏柱泉, 唐纯丽, 等. 局部喷洒曲安奈德联合球囊扩张治疗良性中央气道狭窄疗效研究. 新医学, 2016, 47(11): 742-746.
11.	肖阳宝, 罗莉, 罗林紫, 等. 局部注射曲安奈德联合常规介入方法治疗结核性支气管瘢痕狭窄. 当代医学, 2018, 24(22): 35-37.
12.	蔡向敬, 侯玉莲, 段月庭, 等. 支气管镜下球囊高压扩张联合曲安奈德局部注射治疗结核性支气管狭窄的效果观察. 河北医学, 2017, 23(12): 1956-1958.
13.	雷小婷, 孟泳, 包爱华, 等. 气管镜下球囊扩张联合曲安奈德局部注射治疗气道狭窄的远期疗效. 中国实用医刊, 2019, 46(4): 11-14.
14.	马建永, 李春. 曲安奈德结合常规介入治疗难治性良性中央气道狭窄疗效及安全性评价. 中国初级卫生保健, 2013, 27(4): 118-119.
15.	齐亚丽, 顾玉海, 李龙昱, 等. 局部注射曲安奈德结合常规介入方法治疗难治生良性中央气道狭窄疗效及安全性的初步探讨. 黑龙江医药, 2016, 29(4): 699-700.
16.	龙发, 周爱莲, 李俊华, 等. 电子支气管镜下球囊高压扩张加曲安奈德注射治疗结核性支气管狭窄的临床研究. 临床内科杂志, 2015, 32(11): 782-783.
17.	Guibert N, Didier A, Moreno B, et al. Treatment of complex airway stenoses using patient-specific 3 D-engineered stents: a proof-of-concept study. Thorax, 2019, 74(8): 810-813.
18.	Fiorelli A, Poggi C, Ardo NP, et al. Flow-volume curve analysis for predicting recurrence after endoscopic dilation of airway stenosis. Ann Thorac Surg, 2019, 108(1): 203-210.
19.	Rezende MU, Andrusaitis FR, Silva RT, et al. Joint lavage followed by viscosupplementation and triamcinolone in patients with severe haemophilic arthropathy: objective functional results. Haemophilia, 2017, 23(2): e105-e115.
20.	Elavarasi A, Goyal V, Singh MB, et al. Is triamcinolone an easy and efficient way to treat meralgia paresthetica? A Cohort Study. Ann Indian Acad Neurol, 2019, 22(3): 308-310.
21.	McSwiney TJ, Power B, Murphy CC, et al. Safety and efficacy of supratarsal triamcinolone for treatment of vernal keratoconjunctivitis in Ireland. Cornea, 2019, 38(8): 955-958.

1. Xiong XF, Xu L, Fan LL, et al. Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study. BMC Pulm Med, 2019, 19(1): 33.
2. Fortin M, Lacasse Y, Elharrar X, et al. Safety and efficacy of a fully covered self-expandable metallic stent in benign airway stenosis. Respiration, 2017, 93(6): 430-435.
3. Kniese CM, Musani AI. Interventional pulmonology: a focused review for primary care physicians. Med Clin North Am, 2019, 103(3): 399-412.
4. Michaud G. Review of recent important papers in interventional pulmonology. Semin Thorac Cardiovasc Surg, 2018, 30(2): 212-214.
5. Mondoni M, Radovanovic D, Sotgiu G, et al. Interventional pulmonology techniques in elderly patients with comorbidities. Eur J Intern Med, 2019, 59: 14-20.
6. Khan HA, Sahibzada MN, Paracha MM. Comparison of the efficacy of intralesional bleomycin versus intralesional triamcinolone acetonide in the treatment of keloids. Dermatol Ther, 2019, 32(5): e13036.
7. 陈愉, 伍惠仪, 李时悦, 等. 局部注射曲安奈德结合常规介入方法治疗难治性良性中央气道狭窄疗效及安全性的初步探讨. 中华结核和呼吸杂志, 2012, 35(6): 415-418.
8. 李志东, 陈思宇, 肖谊, 等. 气管镜下介入高压球囊扩张联合局部注射激素治疗气道狭窄的临床研究. 中国药物经济学, 2014, 9(S1): 404-405.
9. 胡鑫, 张会云, 边南南, 等. 第二代ALK抑制剂治疗ALK⁺非小细胞肺癌有效性单组率的Meta分析. 中国循证医学杂志, 2018, 18(9): 918-923.
10. 周子青, 苏柱泉, 唐纯丽, 等. 局部喷洒曲安奈德联合球囊扩张治疗良性中央气道狭窄疗效研究. 新医学, 2016, 47(11): 742-746.
11. 肖阳宝, 罗莉, 罗林紫, 等. 局部注射曲安奈德联合常规介入方法治疗结核性支气管瘢痕狭窄. 当代医学, 2018, 24(22): 35-37.
12. 蔡向敬, 侯玉莲, 段月庭, 等. 支气管镜下球囊高压扩张联合曲安奈德局部注射治疗结核性支气管狭窄的效果观察. 河北医学, 2017, 23(12): 1956-1958.
13. 雷小婷, 孟泳, 包爱华, 等. 气管镜下球囊扩张联合曲安奈德局部注射治疗气道狭窄的远期疗效. 中国实用医刊, 2019, 46(4): 11-14.
14. 马建永, 李春. 曲安奈德结合常规介入治疗难治性良性中央气道狭窄疗效及安全性评价. 中国初级卫生保健, 2013, 27(4): 118-119.
15. 齐亚丽, 顾玉海, 李龙昱, 等. 局部注射曲安奈德结合常规介入方法治疗难治生良性中央气道狭窄疗效及安全性的初步探讨. 黑龙江医药, 2016, 29(4): 699-700.
16. 龙发, 周爱莲, 李俊华, 等. 电子支气管镜下球囊高压扩张加曲安奈德注射治疗结核性支气管狭窄的临床研究. 临床内科杂志, 2015, 32(11): 782-783.
17. Guibert N, Didier A, Moreno B, et al. Treatment of complex airway stenoses using patient-specific 3 D-engineered stents: a proof-of-concept study. Thorax, 2019, 74(8): 810-813.
18. Fiorelli A, Poggi C, Ardo NP, et al. Flow-volume curve analysis for predicting recurrence after endoscopic dilation of airway stenosis. Ann Thorac Surg, 2019, 108(1): 203-210.
19. Rezende MU, Andrusaitis FR, Silva RT, et al. Joint lavage followed by viscosupplementation and triamcinolone in patients with severe haemophilic arthropathy: objective functional results. Haemophilia, 2017, 23(2): e105-e115.
20. Elavarasi A, Goyal V, Singh MB, et al. Is triamcinolone an easy and efficient way to treat meralgia paresthetica? A Cohort Study. Ann Indian Acad Neurol, 2019, 22(3): 308-310.
21. McSwiney TJ, Power B, Murphy CC, et al. Safety and efficacy of supratarsal triamcinolone for treatment of vernal keratoconjunctivitis in Ireland. Cornea, 2019, 38(8): 955-958.

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Efficacy and safety of local triamcinolone combined with conventional interventional therapy in treatment of benign airway stenosis: a meta-analysis

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