Tonnel A B, Bons J, Legendre M, Prud'Homme A, Bugnas B, Evano-Celli I, Stuart A M
Clinique des Maladies Respiratoires, Chru de Lille, Hôpital Calmette, France.
Respir Med. 2000 Jun;94 Suppl B:S29-34.
This study compared the efficacy and safety of the fluticasone propionate 125 microg pressurized metered dose inhaler (pMDI) propelled by either hydrofluoroalkane (HFA) 134a or chlorofluorocarbon (CFC) propellants, in adult patients with asthma. HFA 134a is a non-ozone depleting propellant used as a replacement for the CFC propellants 11 and 12 which are being phased out in accordance with the Montreal Protocol. Three hundred and eighty patients with mild to moderate asthma and 'room for improvement' in their treatment were randomized to receive fluticasone propionate 250 microg twice daily via pMDIs propelled by either CFC propellants 11 and 12 (n = 195) or HFA 134a (n = 185). Fluticasone propionate significantly improved lung function over the 4-week treatment period in both treatment groups. The improvement in mean morning peak expiratory flow (PEF) after 7 days of treatment was approximately 12 l min(-1) in both groups, rising to approximately 22 l min(-1) at the end of the 4-week treatment period. The adjusted mean difference between the two formulations over weeks 1-4 was -1 l min(-1) (90% confidence interval: -7, 5 l min(-1)), confirming their equivalence. Clinical comparability was also demonstrated with respect to secondary efficacy variables, including daily symptom scores, evening PEF and clinic visit expiratory measurements. There were no clinically relevant differences in adverse events or serum cortisol levels between the two groups. The fluticasone propionate 125 microg HFA 134a pMDI is an effective and well tolerated product and is a suitable replacement for the fluticasone propionate 125 microg CFC pMDI at a microgram equivalent dose.
本研究比较了以氢氟烷烃(HFA)134a或氯氟烃(CFC)为推进剂的125微克丙酸氟替卡松定量气雾剂(pMDI)在成年哮喘患者中的疗效和安全性。HFA 134a是一种不消耗臭氧层的推进剂,用作正在根据《蒙特利尔议定书》逐步淘汰的CFC推进剂11和12的替代品。380例轻度至中度哮喘且治疗上“有改善空间”的患者被随机分组,分别接受由CFC推进剂11和12(n = 195)或HFA 134a(n = 185)推进的pMDI,每日两次吸入250微克丙酸氟替卡松。在4周的治疗期内,两个治疗组中丙酸氟替卡松均显著改善了肺功能。治疗7天后,两组的平均晨起呼气峰流速(PEF)改善约为12升/分钟,在4周治疗期结束时升至约22升/分钟。两种制剂在第1 - 4周的校正平均差异为-1升/分钟(90%置信区间:-7, 5升/分钟),证实了它们的等效性。在包括每日症状评分、夜间PEF和门诊呼气测量等次要疗效变量方面也显示出临床可比性。两组在不良事件或血清皮质醇水平方面无临床相关差异。125微克HFA 134a丙酸氟替卡松pMDI是一种有效且耐受性良好的产品,在微克等效剂量下是125微克CFC丙酸氟替卡松pMDI的合适替代品。