成人哮喘患者带状疱疹的总体负担：系统回顾和荟萃分析
2024/07/30
摘要
背景：哮喘是一种常见的呼吸道疾病，可能与带状疱疹（HZ）风险的增加有关，而带状疱疹通常是一种伴有剧痛的衰弱性疾病。这是第一篇系统性综述，旨在总结成人哮喘患者 HZ 负担的证据。
方法：就成人（≥18 岁）哮喘患者的 HZ 负担（发病率、风险、并发症）进行了全面的系统性文献综述 (SLR) 和荟萃分析（Medline 和 Embase，2003-2024 年）。
结果：共纳入了 19 项关于成人哮喘 HZ 结果的研究。在≥18 岁的人群中，HZ的每千人年发病率为 5.71（95% 置信区间 [CI] 4.68-6.96）（＜60 岁的人群为 4.20 [3.09-5.70] 而≥60 岁的人群为 10.33 [9.17-11.64]）。在≥18 岁的人群中，HZ 的总发病率比为 1.23 [1.11-1.35]，在≥50 岁的人群中为 1.36 [1.15-1.61]。使用全身皮质类固醇、长效β受体激动剂加吸入皮质类固醇和 "附加治疗 "的哮喘患者患 HZ 的风险较高。哮喘还与带状疱疹后遗神经痛（比值比，OR 1.21 [1.06-1.37]）和带状疱疹性眼病（OR 1.9 [1.1-3.2]）的风险增加有关。
结论：这项SLR和荟萃分析发现，患有哮喘的成年人患HZ的风险增加，老年组和接受某些治疗(如口服皮质类固醇)的人风险更高。HZ 疫苗适用于成人，包括患有哮喘等合并症的成人，并且可以被视为综合呼吸护理的一部分。
Global herpes zoster burden in adults with asthma: a systematic review and meta-analysis
Mortimer KJ, Cruz AA, Sepúlveda-Pachón IT, Jorga A, Vroling H, Williams C.
Abstract
Background:Asthma is a common respiratory disease, which may be associated with an increased risk of herpes zoster (HZ), often a debilitating disease associated with severe pain. This was the first systematic review with the objective of summarizing evidence on HZ burden in adults with asthma.
Methods:A global systematic literature review (SLR) and meta-analysis was conducted (Medline and Embase, 2003-2024), on HZ burden (incidence, risk, complications) in adults (≥18 years) with asthma.
Results:There were 19 studies included on HZ outcomes in adults with asthma. Pooled HZ incidence per 1000 person-years was 5.71 (95% confidence interval [CI] 4.68-6.96) in ≥18-year-olds (4.20 [3.09-5.70] in <60-year-olds versus 10.33 [9.17-11.64] in ≥60-year-olds). The pooled rate ratio for developing HZ was 1.23 [1.11-1.35] in ≥18-year-olds, and 1.36 [1.15-1.61] in ≥50-year-olds. The risk of HZ was higher in people with asthma using systemic corticosteroids; long-acting beta-agonists plus inhaled corticosteroids; and "add-on therapy". Asthma was also associated with an increased risk of post-herpetic neuralgia (odds ratio, OR 1.21 [1.06-1.37]) and HZ ophthalmicus (OR 1.9 [1.1-3.2]).Differences in study design, setting, case definitions, and follow-up durations led to heterogeneity.
Conclusion:This SLR and meta-analysis found that adults with asthma have an increased risk of HZ, with higher risks in older age groups, and in those on certain treatments, such as oral corticosteroids. HZ vaccines are available for adults, including those with comorbidities such as asthma, and can be considered as part of integrated respiratory care.
背景：哮喘是一种常见的呼吸道疾病，可能与带状疱疹（HZ）风险的增加有关，而带状疱疹通常是一种伴有剧痛的衰弱性疾病。这是第一篇系统性综述，旨在总结成人哮喘患者 HZ 负担的证据。
方法：就成人（≥18 岁）哮喘患者的 HZ 负担（发病率、风险、并发症）进行了全面的系统性文献综述 (SLR) 和荟萃分析（Medline 和 Embase，2003-2024 年）。
结果：共纳入了 19 项关于成人哮喘 HZ 结果的研究。在≥18 岁的人群中，HZ的每千人年发病率为 5.71（95% 置信区间 [CI] 4.68-6.96）（＜60 岁的人群为 4.20 [3.09-5.70] 而≥60 岁的人群为 10.33 [9.17-11.64]）。在≥18 岁的人群中，HZ 的总发病率比为 1.23 [1.11-1.35]，在≥50 岁的人群中为 1.36 [1.15-1.61]。使用全身皮质类固醇、长效β受体激动剂加吸入皮质类固醇和 "附加治疗 "的哮喘患者患 HZ 的风险较高。哮喘还与带状疱疹后遗神经痛（比值比，OR 1.21 [1.06-1.37]）和带状疱疹性眼病（OR 1.9 [1.1-3.2]）的风险增加有关。
结论：这项SLR和荟萃分析发现，患有哮喘的成年人患HZ的风险增加，老年组和接受某些治疗(如口服皮质类固醇)的人风险更高。HZ 疫苗适用于成人，包括患有哮喘等合并症的成人，并且可以被视为综合呼吸护理的一部分。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Eur Respir J. 2024 Jun 20; DOI: 10.1183/13993003.00462-2024)
(Eur Respir J. 2024 Jun 20; DOI: 10.1183/13993003.00462-2024)
Global herpes zoster burden in adults with asthma: a systematic review and meta-analysis
Mortimer KJ, Cruz AA, Sepúlveda-Pachón IT, Jorga A, Vroling H, Williams C.
Abstract
Background:Asthma is a common respiratory disease, which may be associated with an increased risk of herpes zoster (HZ), often a debilitating disease associated with severe pain. This was the first systematic review with the objective of summarizing evidence on HZ burden in adults with asthma.
Methods:A global systematic literature review (SLR) and meta-analysis was conducted (Medline and Embase, 2003-2024), on HZ burden (incidence, risk, complications) in adults (≥18 years) with asthma.
Results:There were 19 studies included on HZ outcomes in adults with asthma. Pooled HZ incidence per 1000 person-years was 5.71 (95% confidence interval [CI] 4.68-6.96) in ≥18-year-olds (4.20 [3.09-5.70] in <60-year-olds versus 10.33 [9.17-11.64] in ≥60-year-olds). The pooled rate ratio for developing HZ was 1.23 [1.11-1.35] in ≥18-year-olds, and 1.36 [1.15-1.61] in ≥50-year-olds. The risk of HZ was higher in people with asthma using systemic corticosteroids; long-acting beta-agonists plus inhaled corticosteroids; and "add-on therapy". Asthma was also associated with an increased risk of post-herpetic neuralgia (odds ratio, OR 1.21 [1.06-1.37]) and HZ ophthalmicus (OR 1.9 [1.1-3.2]).Differences in study design, setting, case definitions, and follow-up durations led to heterogeneity.
Conclusion:This SLR and meta-analysis found that adults with asthma have an increased risk of HZ, with higher risks in older age groups, and in those on certain treatments, such as oral corticosteroids. HZ vaccines are available for adults, including those with comorbidities such as asthma, and can be considered as part of integrated respiratory care.
上一篇：
哮喘及相关疾病患者开始使用生物制剂时间与种族和民族有关，而不仅仅与保险有关
下一篇：
评估特定PM2.5结合的金属元素对哮喘急诊就诊的影响：一项台湾病例交叉研究
