Browsing by Author "Rodrigo, Gustavo Javier"
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- ItemDaily vs. intermittent inhaled corticosteroids for recurrent wheezing and mild persistent asthma : a systematic review with meta-analysis(2013) Rodrigo, Gustavo Javier; Castro Rodríguez, José AntonioBackground Intermittent ICS treatment with SABA in response to symptoms, is an emerging strategy for control of mild-to-moderate asthma, and recurrent wheezing. This systematic revue compares the efficacy of daily vs. intermittent ICS among preschoolers, children and adults with persistent wheezing and mild to moderate stable persistent asthma. Methods Systematic review of randomized, placebo-controlled trials with a minimum of 8 weeks of daily (daily ICS with rescue SABA during exacerbations) vs. intermittent ICS (ICS plus SABA at the onset of symptoms), were retrieved through different databases. Primary outcome was asthma exacerbations; secondary outcomes were pulmonary function tests, symptoms, days without symptoms, SABA use, corticosteroids use, days without rescue medication use, expired nitric oxide and serious adverse events. Results Seven trials (1367 participants) met inclusion criteria there was no statistically significant difference in the rate of asthma exacerbations between those with daily vs. intermittent ICS (0.96; 95% CI: 0.86, 1.06, I2 = 0%). In the sub-group analysis, no differences were seen in duration of studies, step-up strategy or age. However, compared to intermittent ICS, the daily ICS group had a significant increase in asthma-free days and non-significant decreases in rescue SABA use and exhaled nitric oxide measurement. Conclusions No significant differences between daily and intermittent ICS in reducing the incidence of asthma exacerbations was found. However, the daily ICS strategy was superior in many secondary outcomes. Therefore, this study suggests to not change daily for intermittent ICS use among preschoolers, children with persistent wheezing and adults with mild-to-moderate stable persistent asthma.
- ItemEfficacy and safety of subcutaneous omalizumab vs placebo as add-on therapy to corticosteroids for children and adults with asthma: A systematic review(2011) Rodrigo, Gustavo Javier; Neffen, Hugo E.; Castro Rodríguez, José Antonio
- ItemEfficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: A systematic review with meta-analysis(2009) Castro Rodríguez, José Antonio; Rodrigo, Gustavo Javier
- ItemFormoterol for acute asthma in the emergency department: a systematic review with meta-analysis(2010) Rodrigo, Gustavo Javier; Neffen, Hugo E.; Colodenco, Federico Daniel; Castro Rodríguez, José Antonio
- ItemGuía ALERTA 2. América Latina y España: Recomendaciones para la prevención y el tratamiento de la exacerbación asmática(2010) Rodrigo, Gustavo Javier; Plaza Moral, V.; Forns, Santiago Bardagí; Castro Rodríguez, José Antonio; De Diego Damiá, Alfredo; Cortés, Santos Liñán; Melero-Moreno, Carlos; Nannini, Luís Javier; Neffen, Hugo E.; Salas, Jorge Del Diego
- ItemHeliox-driven ß2-agonists nebulization for children and adults with acute asthma : A systematic review with meta-analysis(2014) Rodrigo, Gustavo Javier; Castro Rodríguez, José AntonioBackground The effect of heliox as a nebulizer β2-agonist driving gas in acute asthma remains controversial. Objective To perform a systematic review with a meta-analysis of randomized trials designed to evaluate the efficacy of heliox versus oxygen in driving β2-agonist nebulization in patients with acute asthma. Methods A search was conducted of all randomized controlled trials published before August 2013. Primary outcomes were change in spirometric measurements and severity composite score (pediatric studies); secondary outcomes were hospitalizations and serious adverse effects. Results Eleven trials from 10 studies (697 participants) met the inclusion criteria (7 included adults and 3 included children). The mean duration of heliox therapy was 120 minutes and the most common helium-oxygen mixture used was 70:30. Patients receiving heliox presented a statistically significant difference for mean percentage of change in peak expiratory flow (17.2%; 95% confidence interval 5.2-29.2, P =.005). Post hoc subgroup analysis showed that patients with severe and very severe asthma showed a significant improvement in peak expiratory flow compared with those with mild to moderate acute asthma. Heliox-driven nebulization also produced significant decreases in the risk of hospitalizations (odds ratio 0.49, 95% confidence interval 0.31-0.79, P =.003) and severity of exacerbations (pediatric studies; standard mean difference -0.74, 95%% confidence interval -1.45 to -0.03, P =.04). There were no group differences for serious adverse effects. Conclusion This review suggests that heliox benefits in airflow limitation and hospital admissions could be considered clinically significant. Data support the use of heliox as a nebulizing β2-agonist driving gas in the routine care of patients with acute asthma.
- ItemSafety and efficacy of combined long-acting β-agonists and inhaled corticosteroids vs long-acting β-agonists monotherapy for stable COPD: A systematic review(2009) Rodrigo, Gustavo Javier; Castro Rodríguez, José Antonio; Plaza, Vicente
- ItemSafety of long-acting β agonists for the treatment of asthma: Clearing the air(2012) Rodrigo, Gustavo Javier; Castro Rodríguez, José AntonioConcerns about the safety of long-acting β2-agonist (LABA) therapy, has led to the appearance of multiple publications and recommendations. This review critically examines the available clinical evidence and safety requirements for LABA use. On the basis of nearly 20 systematic reviews and databases, the authors conclude that LABA monotherapy significantly increases the risk of asthma-related adverse effects. We also conclude that the use of LABAs concomitantly with inhaled corticosteroids (ICS) significantly reduces asthma hospitalisations and is not associated with life-threatening events and asthma-related deaths, especially when concurrent use of LABAs and ICS can be reasonably assured (use of a single inhaler device). An appropriate clinical study would require an extremely large sample, making it impractical. Finally, some of the new US Food and Drug Administration (FDA) recommendations have caused confusion and do not appear to be fully evidence based. Although limited by low statistical power, the evidence supports the use of LABAs plus ICS in a single inhaler device (to increase adherence and reduce the potential use of LABA monotherapy) for all patients (not only children) with moderate to severe asthma.
- ItemSafety of long-acting β-agonists in asthma(2012) Rodrigo, Gustavo Javier; Castro Rodríguez, José Antonio
- ItemSafety of regular use of long-acting beta agonists as monotherapy or added to inhaled corticosteroids in asthma. A systematic review(2009) Rodrigo, Gustavo Javier; Plaza Moral, Vicente; García-Marcos, Luis; Castro Rodríguez, José Antonio
- ItemThe role of inhaled corticosteroids and montelukast in children with mild-moderate asthma: Results of a systematic review with meta-analysis(2010) Castro Rodríguez, José Antonio; Rodrigo, Gustavo Javier
- ItemTiotropium and risk for fatal and nonfatal cardiovascular events in patients with chronic obstructive pulmonary disease: Systematic review with meta-analysis(2009) Rodrigo, Gustavo Javier; Castro Rodríguez, José Antonio; Nannini, Luís Javier; Plaza Moral, Vicente; Schiavi, Eduardo A.
- ItemTiotropium for the treatment of adolescents with moderate to severe symptomatic asthma : a systematic review with meta-analysis(2015) Rodrigo, Gustavo Javier; Castro Rodríguez, José Antonio