Source: Annual Congress 2002 - Acute exacerbations of COPD: aetiology and therapy
Disease area: Airway diseases

Abstract

Objectives: This is to answer the following questions: (1) Does the use of IM significantly reduce the frequency of RRTI in children and in adults? (2) Does it help in preventing exacerbations in chronic obstructive pulmonary disease (COPD)?
Search Strategy: Randomized controlled trials were identified through Medline, Pub Med (1980-2000), Cochrane Controlled-trials register, and by manual searches and cross-references. All languages were considered.
Data analysis: Two reviewers independently extracted data.Discrepancy in results was resolved through a third reviewer. Analysis of data was done using Review Manager 4.0.
Main Outcome measures: Reduction in the frequency of RRTI in healthy children and adults, including exacerbation of COPD in adults.
Results: In children, a 622 patients from the 5 RCTs were evaluated. Overall analyses showed significant reduction in the frequency of RRTI in children [OR:0. 37; 95% CI 0.25,0.54; chi-square for heterogeneity=1.44, p=0.84; over-all effect p<0.00001]. In adults, out of the 11 studies 5 were analyzed. Total of 1119 patients were included and 563 were treated with IM. Pooled odds ratio was not determined due to significant heterogeneity of the studies included [chi-square for heterogeneity=22.74, p=0.0001]. Although, all trials demonstrated significant reduction in RRTI, 2 studies showed extreme values favoring treatment. With regard to the effect in reduction of exacerbation in COPD, IM has no significant difference with placebo [OR:0.95; 95% CI 0.66,1.36; chi-square for heterogeneity=1.67, p=0.8; over-all effect p=0.8].
Conclusion: IM prevents RRTI in children and adults but does not reduce exacerbations in COPD patients.

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M. L. Y. Villaroman, L. J. Codamos, M. A. S. Gappi, M. A. de Castro (Quezon City, The Philippines). Immunomodulators in preventing recurrent respiratory tract infections (RRTI): a meta-analysis*. Eur Respir J 2002; 20: Suppl. 38, 3380

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