LI Jianrong 1 , LIU Fengqi 1 , LIU Zuoxiang 1 , PENG Hexiang 1 , ZENG Xueyang 1 , CHEN Yahong 2 , WU Tao 1,3 , SUN Feng 1,3,4
  • 1. Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, P. R. China;
  • 2. Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100191, P. R. China;
  • 3. Key Laboratory of Epidemiology of Major Diseases (Peking University), Beijing 100191, P. R. China;
  • 4. Peking University Center for Evidence Based Medicine and Clinical Research, Beijing 100191, P. R. China;
WU Tao, Email: twu@bjmu.edu.cn; SUN Feng, Email: sunfeng@bjmu.edu.cn
Asthma; Children and adolescents; Asthma symptom score; Network meta-analysis
10.7507/1672-2531.202309050
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Objectives To evaluate the improvement of symptoms in patients with moderate to severe asthma aged 5-18 years treated with GINA (Global Initiative for Asthma) guidelines by network meta-analysis. Methods  Randomized controlled trials (RCTs) about asthma patients aged 5 to 18 years old with reported asthma symptom scores were collected from PubMed, Embase, Cochrane Library, CNKI, WanFang Data, VIP, SinoMed and clinical trial registry platform ClinicalTrials.gov. The search time limit was from the establishment of the database to August 26, 2023. After two researchers independently screened literatures, extracted data and evaluated the risk of bias of included studies, Stata 15.0 software was used for network meta-analysis. Results A total of 23 studies were included, of which 23 RCT reported daytime asthma symptom scores. Compared with symptom scores in the low-dose ICS group, there was a statistically significant difference in improvement of daytime symptoms between low-dose ICS+LABA+LTRA (SMD=−1.4, 95%CI −1.99 to −0.81) and low-dose ICS+LABA+SABA (SMD=−1.43, 95%CI −2.48 to −0.39). Symptom scores for nighttime asthma were reported in 20 RCT, and there was a statistically significant difference in symptom scores for low-dose ICS+LABA+LTRA (SMD=−1.20, 95%CI −2.20 to −0.21) compared with the low-dose ICS group. After the ranking of efficacy, the number one asthma symptom score in both daytime and nighttime was low-dose ICS+LABA+LTRA group. Conclusion Low dose ICS+LABA+LTRA has the best efficacy in improving daytime and nighttime asthma symptom scores.