Efficacy And Safety Of Fluticasone Furoate In The Treat Of Bronchial Asthma:a Systematic Review

Objective: To systematically evaluate the clinical efficacy and safety of fluticasone furoate in the treatment of bronchial asthma.Methods: We electronically searched databases including VIP datebases,Wan Fang Data,The Cochrane Library(Issue 2,2016),Pub Med and CNKI to collect randomized controlled trial(RCT)about fluticasone furoate for bronchial asthma from inception to Feb.2016.Two reviewers independently screened literature,extracted data and evaluated the risk of bias of included studies.Then,Rev Man 5.3 software was used for meta-analysis.Results: A total of Six randomized controlled trails involving a total of 4383 patients were included.The results of meta-analysis showed that:(1)Fluticasone furoate vs.placebo: fluticasone furoate could not only significantly improve trough FEV1(MD=0.10,95%CI 0.05 to 0.15,P=0.000 2),but also improve the percentage of rescue-free in 24 hours and the symptom-free periods in 24 hours.Meanwhile,fluticasone furoate could not increase the adverse events rate(OR=1.38,95%CI 0.28 to 6.77,P=0.69).(2)Fluticasone furoate plus vilanterol vs.fluticasone furoate alone: Compared with fluticasone furoate alone,fluticasone furoate plus vilanterol could significantly improve FEV1(MD=-0.10,95%CI-0.19 to-0.01,P=0.02)and 0-24 h wm FEV1(MD=-0.10,95%CI-0.19 to-0.01,P=0.02).the combination therapy also had better percentage of rescue-free in 24 hours and symptom-free periods in 24 hours without increasing rate of adverse events(OR=-1.05,95%CI-1.39 to-0.80,P=0.72).(3)Fluticasone furoate vs.fluticasone propionate: There were no significant differences between fluticasone furoate and fluticasone propionate in FEV1(MD=-0.02,95%CI-0.08 to 0.04,P=0.52),percentage of rescue-free in 24 hours and adverse events rate(OR=1.62,95%CI 0.77 to 3.40,P=0.20).Conclusion: Current evidence shows,fluticasone furoate could effectively improve the lung function and control the symptoms of asthma patients than placebo;fluticasone furoate plus vilanterol shows better effects than fluticasone furoate alone without increasing the adverse event rate.Fluticasone furoate and fluticasone propionate have similar effects,but fluticasone furoate is more convenient therapeutic method,so that could improve patients’ adherence and the control of asthma symtoms.The quality of research methods is generally high included in this study,due to the limited quality,specially to the small sample of each grouple,more strict implementation,multicenter,big sample and systematizatiom studies are needed to verify the above conclusion.