TY -的T1 -大剂量吸入糖皮质激素的口服steroid-sparing效应哮喘JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.01147 -2019欧元六世- 55 - 1 SP - 1901147 AU Maijers英格丽德盟,卡恩斯年AU -哈珀,詹姆斯盟——因此,马克AU -比斯利,高剂量吸入糖皮质激素(ICS)治疗由全身效应引起的口服糖皮质激素依赖性哮喘的疗效比例尚不确定。本研究旨在评估口服糖皮质激素依赖哮喘患者口服糖皮质激素保留作用的ICS剂量-反应关系，并确定口服糖皮质激素保留作用由于其全身效应的比例。基于ICS与口服皮质激素对肾上腺抑制的比较剂量-反应关系。方法系统回顾和荟萃分析报道大剂量ICS保留口服糖皮质激素对口服糖皮质激素依赖性哮喘疗效的随机对照试验。此外，我们还获得了口服皮质类固醇与ICS在肾上腺抑制方面的剂量等效性报道。主要结果是ICS保留口服糖皮质激素作用可归因于系统吸收的比例，每1000µg ICS增加，以比值表示。这一比例估计了ICS由于全身效应而产生的口服皮质类固醇保留效应。结果确认了11项研究，包括1283名参与者报告了ICS的口服皮质类固醇保留效应。在ICS中，强的松的剂量每增加1000µg从2.1 mg到4.9 mg不等，这取决于ICS的类型。 The ratio of the prednisone-sparing effect due to the systemic effects per 1000 µg of fluticasone propionate was 1.02 (95% CI 0.68–2.08) and for budesonide was 0.93 (95% CI 0.63–1.89).Conclusion In patients with oral corticosteroid-dependent asthma, the limited available evidence suggests that the majority of the oral corticosteroid-sparing effect of high-dose ICS is likely to be due to systemic effects.In oral corticosteroid-dependent asthma, the majority of the oral corticosteroid-sparing effects of high-dose inhaled corticosteroids (ICS) are due to their systemic effects. Clinicians should be aware of this bioequivalence when prescribing high-dose ICS. http://bit.ly/2m0Fa8m ER -