Evaluating the therapeutic benefit of bacterial lysates in chronic obstructive pulmonary disease: a systematic review and meta-analysis
11 affiliations
- 1College of Pharmacy, King Khalid University, Abha, Saudi Arabia
- 2Respiratory Therapy, Almaarefa University, Riyadh, Saudi Arabia
- 3Respiratory Therapy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- 4College of Medicine, King Khalid University, Abha, Saudi Arabia
- 5College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- 6College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- 7College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- 8College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- 9UCL Respiratory, University College London, London, United Kingdom
- 10Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- 11Respiratory Therapy Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
Abstract
Background: Chronic obstructive pulmonary disease (COPD) with exacerbations often triggered by infections. Bacterial lysates have been investigated as interventions to reduce the exacerbations of COPD.
Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating bacterial lysates (BLs) in adults with chronic obstructive pulmonary disease (COPD). PubMed, EMBASE, CENTRAL, Web of Science, Google Scholar, ICTRP, and ClinicalTrials.gov were searched. In adults with COPD that compared bacterial lysates with placebo or conventional COPD therapy. Primary outcomes were the effect of BLs on exacerbations and duration. Secondary outcomes were hospitalisation risk, the mean number of exacerbations per participant during trial follow up, symptom scores for dyspnoea, sputum, cough, and adverse events. We used random-effects meta-analysis, assessed risk of bias with Cochrane RoB 2, graded certainty with GRADE.
Results: Fifteen RCTs were included. The pooled risk ratio (RR) for exacerbation in patients with COPD treated with BLs vs. control was 0.83 (95% CI 0.74–0.93; P = 0.0009). The mean difference (MD) for exacerbation duration showed no statistical significant reduction −9.26 Days (95% CI −19.56 to 1.03; P = 0.08). Mean number of exacerbations (MD) −0.19 (95% CI −0.30 to −0.08; P = 0.0009). Hospitalisation RR was 0.52 (95% CI 0.35–0.78; P = 0.001).Symptom outcomes were dyspnoea standardised mean difference (SMD) −0.42 (95% CI −0.75 to −0.10; P = 0.01), cough (SMD) −0.37 (95% CI −0.63 to −0.11; P = 0.006), while sputum production showed no significant change (SMD) −0.20 (95% CI −0.65 to 0.25; P = 0.39), The RR for adverse events was 0.95 (95% CI 0.86–1.04; P = 0.27).
Conclusion: Bacterial lysates may be associated with lower COPD exacerbation and hospitalisation risk, with small numerical improvements in dyspnoea, cough, sputum production showed no significant improvement; effects varied by formulation, these findings require confirmation in formulation specific trials.
Systematic Review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024570783, PROSPERO CRD42024570783.
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BibTeX
@article{almujadib2026evaluating,
title = {{Evaluating the therapeutic benefit of bacterial lysates in chronic obstructive pulmonary disease: a systematic review and meta-analysis}},
author = {Azizah Almujadib and Reham Alotaibi and Aseel Alsultan and Reem Alshehri and Haneen H. Alzahrani and Noor Almahfoodh and Bassam Asiri and Shaden Alsulami and Shahad Alghool and Ghidi Saddiqi and John R. Hurst and Hajed M. Alotaibi and Malik A. Althobiani},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1928291},
url = {https://doi.org/10.3389/fmed.2026.1928291},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Evaluating the therapeutic benefit of bacterial lysates in chronic obstructive pulmonary disease: a systematic review and meta-analysis
AU - Azizah Almujadib
AU - Reham Alotaibi
AU - Aseel Alsultan
AU - Reem Alshehri
AU - Haneen H. Alzahrani
AU - Noor Almahfoodh
AU - Bassam Asiri
AU - Shaden Alsulami
AU - Shahad Alghool
AU - Ghidi Saddiqi
AU - John R. Hurst
AU - Hajed M. Alotaibi
AU - Malik A. Althobiani
PY - 2026
DA - 2026/10/21
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1928291
UR - https://doi.org/10.3389/fmed.2026.1928291
AB - Background: Chronic obstructive pulmonary disease (COPD) with exacerbations often triggered by infections. Bacterial lysates have been investigated as interventions to reduce the exacerbations of COPD. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating bacterial lysates (BLs) in adults with chronic obstructive pulmonary disease (COPD). PubMed, EMBASE, CENTRAL, Web of Science, Google Scholar, ICTRP, and ClinicalTrials.gov were searched. In adults with COPD that compared bacterial lysates with placebo or conventional COPD therapy. Primary outcomes were the effect of BLs on exacerbations and duration. Secondary outcomes were hospitalisation risk, the mean number of exacerbations per participant during trial follow up, symptom scores for dyspnoea, sputum, cough, and adverse events. We used random-effects meta-analysis, assessed risk of bias with Cochrane RoB 2, graded certainty with GRADE. Results: Fifteen RCTs were included. The pooled risk ratio (RR) for exacerbation in patients with COPD treated with BLs vs. control was 0.83 (95% CI 0.74–0.93; P = 0.0009). The mean difference (MD) for exacerbation duration showed no statistical significant reduction −9.26 Days (95% CI −19.56 to 1.03; P = 0.08). Mean number of exacerbations (MD) −0.19 (95% CI −0.30 to −0.08; P = 0.0009). Hospitalisation RR was 0.52 (95% CI 0.35–0.78; P = 0.001).Symptom outcomes were dyspnoea standardised mean difference (SMD) −0.42 (95% CI −0.75 to −0.10; P = 0.01), cough (SMD) −0.37 (95% CI −0.63 to −0.11; P = 0.006), while sputum production showed no significant change (SMD) −0.20 (95% CI −0.65 to 0.25; P = 0.39), The RR for adverse events was 0.95 (95% CI 0.86–1.04; P = 0.27). Conclusion: Bacterial lysates may be associated with lower COPD exacerbation and hospitalisation risk, with small numerical improvements in dyspnoea, cough, sputum production showed no significant improvement; effects varied by formulation, these findings require confirmation in formulation specific trials. Systematic Review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024570783, PROSPERO CRD42024570783.
SN - 2296-858X
ER -