| Background:The routine treatment for bronchial asthmapatients is ICS/LABA/LAMA,LTRA,sustained-release theophylline drugs,etc.For some phenotypes and relapsed and refractory asthma,it is necessary to seek additional treatments other than conventional treatment.The statins are commonly used in cardiovascular diseases,and the effectiveness and value as one of add-on therapies in asthma patients in clinical trials remains controversial.Objective:Meta-analysis was used to evaluate the efficacy of statins as an additional treatment based on conventional treatment in asthma patients.Methods:Randomized controlled trials on the efficacy of statins in asthma patients were searched in electronic databases from inception up to March,2019.At the same time,we traced the references listed in the literature and related systematic review literature.According to the inclusion and exclusion criteria,the relevant literature were extracted and the quality of the data were assessed.Review Manager 5.3 software was used for meta-analysis.Results: This meta-analysis includes 14 randomized controlled clinical trials with a total of 972 samples,included 5 English literatures,and 9 Chinese literatures,including stable asthma patients with smokers,obese people,and patients with hyperlipidemia.Comparing to different endpoints,the effects of statins as one of an additional treatment on lung function,restricted symptom control activity,peripheral blood eosinophil count,IgE and TNF? in stable asthma patients were analyzed.In an analysis of the effects of statins as an add-on therapy on lung function in patients with stable asthma,our results showed that statins did not improve the absolute value ofFEV1 in patients compared with the control group before inhaling ICS/SABA/LABA.The combined effect value MD=0.08,95% CI is(-0.08,0.23),P=0.34.After inhalation of ICS/SABA/LABA,the statins increased the absolute value of FEV1 in asthma patients compared with the control group.The combined effect value of MD=0.25,95% CI is(0.04,0.47).P = 0.02.Compared with the control group,statins can increase PEF in asthma patients with a combined effect value MD=47.42,95% CI(45.33,49.52),P<0.00001.In the analysis of statin as an additional therapy for symptom control and activity limitation in patients with stable asthma,the results showed that statins did not improve the AQLQ score,MD=0.16,95% CI is(-0.04,0.36),P=0.12,but can reduce the ACQ score,the combined effect value MD and 95%CI is MD=-0.26,95% CI is(-0.45,-0.06),P=0.01.Compared with the control group,the statins can improve the ACT score in the experimental group,the combined effect value MD=2.89,95% CI(2.59,3.18),P<0.0001.In the analysis of the effects of statins as an additional treatment on peripheral blood eosinophil counts,IgE,and TNF? in patients with stable asthma,statins reduced blood EOS count,IgE,and TNF? levels in the experimental group compared with the control group.The combined effect value MD=-64.31,95% CI is(-79.84,-48.79),P<0.00001;MD=-37.93,95% CI(-49.32,-26.53)),P < 0.00001;MD =-0.28,95% CI(-0.36,-0.19),P < 0.00001.Conclusions: Our meta-analysis showed that the statins as one of add-on therapies for chronic asthma patients can improve lung function to some extent,improve symptom control,and reduce EOS,IgE,and TNF? levels in peripheral blood of asthma patients.But the conclusions require more experimental results to support.Considering the use of statins and the prevalence of asthma,more and better design studies are needed to determine whether there is a specific asthma phenotype that can benefit from statin therapy. |
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