RESUMEN
@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> The study aimed to evaluate efficacy of tiotropium as add-on therapy on top of standard regimens for uncontrolled asthma, specifically in terms of FEV1, morning and evening PEF, reduction in exacerbations, rescue medication use, and quality of life improvement.<br /><strong>METHODS:</strong> A search was done for eligible trials after which validity screen and data extraction was performed. Results were presented as mean differences, standard errors, and 95% confidence intervals, and graphically as forest plots. Estimates were pooled using the random effects model with I2 and Chi2 tests used to assess heterogeneity. Adverse events were reported as dichotomous variables.<br /><strong>RESULTS:</strong> Four studies were included totaling 1617 participants. The tiotropium group had statistically significant improvement in FEV1 (95% Cl, 0.14 [0.09, 0.19], p<0.00001), morning (95% Cl, 20.03 [11.71, 28.35], p<0.00001) with trend towards benefit in reduction of rescue medications (95% Cl, 0.12 [-0.17,0.4],p=0.42) and quality of life improvements (95% Cl, 0.1 [-0.05,0.25], p=0.20). Homogeneity (I2= 0%, Chi2= 0.47-3.22) was found across studies.<br /><strong>CONCLUSION:</strong> Tiotropium is associated with significant improvement in pulmonary function among patients with uncontrolled asthma, with possible benefit in reduction of rescue medications and quality of life improvement.</p>
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Asma , Broncodilatadores , Intervalos de Confianza , Calidad de Vida , Fenómenos Fisiológicos Respiratorios , Derivados de Escopolamina , Bromuro de Tiotropio , MetaanálisisRESUMEN
OBJECTIVE: The study aimed to evaluate the relationships between disease activity, functional capacity, and health-related quality of life (HRQoL) in Filipino patients with ankylosing spondylitis (AS).METHODS: Filipino AS patients gathered from the Rheumatology Clinic of the Philippine General Hospital (PGH) and from selected tertiary hospitals in Metro Manila who have been diagnosed via the Revised New York Criteria were included. Disease activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), while functional capacity and HRQoL were measured using the Bath Ankylosing Spondylitis Functional Index (BASFI) and Short Form (SF)-36, respectively. Pearson's correlation was used to analyze the relationship between BASDAI and BASFI, and between BASDAI and SF-36.RESULTS: Twenty-four patients entered the study. Mean age was 38.75 ± 12.7 years and mean age at diagnosis was 31 ± 12.29 years. Symptoms occurred for a mean of 9.0 ± 6.97 years with mean duration of symptom onset to diagnosis of 3.38 ± 5.14 years. Study subjects had mild to moderate disease activity. Functional capacity was most impaired in performing a full day's activities at home or at work. HRQoL was highest in vitality and lowest in emotional role, with mental health components generally showing higher scores than physical health components. Pearson's correlation showed moderate positive correlation between BASDAI and BASFI (r=0.6016, p=0.0012) and moderate negative correlation between BASDAI and the physical health domain (r= -0.6916, p=0.0001) and mental health domain (r= -0.3575, p=0.0863) of SF-36. However, only the first two correlations were statistically significant.CONCLUSION: Filipino AS patients with higher disease activity have more functional disability and poorer physical HRQoL.