Safety and efficacy of inhaled mannitol in patients with cystic fibrosis: Metanalysis

BackgroundCystic fibrosis is a multi-system autosomal recessive disorder with considerable mortality and morbidity associated with respiratory manifestations. Due to thick, viscous mucus production, which causes airway obstruction and subsequent respiratory infections, multiple drugs are being used to clear the secretions. Inhaled mannitol is one treatment regime that acts by increasing mucociliary clearance; however, its exact mechanism of action is unknown. Consequently, it has produced effective results in multiple studies. AimsTo determine whether inhaled mannitol is efficacious and safe in treating cystic fibrosis. To assess and compare the therapeutic advantages and the adverse effects. MethodsThis systematic review followed the Cochrane Collaborations guidelines and the PRISMA format. Relevant literature was derived from databases like Medline, the Cochrane Central Register of RCTs, PubMed Central, and clinicaltrials.gov. Recent research conduction: February 29th, 2022. Selection criteria included all randomized control trials assessing diagnosed CF patients, evaluating the efficacy of inhaled mannitol, and comparing it with a placebo. The authors independently assessed studies for inclusion, carried out data extraction, and assessed the risk of bias in the included studies. ResultsA total of 6 RCTs were included, containing --- participants with diagnosed CF. The outcome measure was an increase in FEV1 after inhalation of dry mannitol. Additionally, it was also found to be associated with adverse events like cough (p-value <0.051, OD ratio 1.665), hemoptysis (p-value < 0.469, OD ratio 1.311), and chest discomfort. However, these symptoms were managed conservatively, and ultimately, the intervention proved tolerable. ConclusionInhaled mannitol has been shown to improve pulmonary function and mucociliary clearance, relieving some of the symptoms of Cystic fibrosis. However, there is no evidence of improving the overall quality of life and general health. This review suggests that mannitol could be considered as a treatment for cystic fibrosis.