Corren J, Berkowitz R, Murray J J, Prenner B
Allergy Research Foundation, Los Angeles, California 90025, USA.
Int J Clin Pract. 2003 Sep;57(7):567-72.
We conducted this study to compare the efficacy and safety of once-daily mometasone furoate (MF) administered by dry powder inhaler (DPI) with once-daily budesonide (BUD)-DPI and placebo in patients with moderate persistent asthma previously using twice-daily inhaled corticosteroids. A total of 262 patients (> or = 12 years of age) with moderate persistent asthma were randomised to once-daily morning treatment with MF-DPI 440 microg (metered dose), BUD-DPI 400 microg (metered dose), or placebo in an eight-week, multicentre, placebo-controlled, double-blind, double-dummy study. The primary efficacy variable was percent change in FEV1 from baseline to endpoint (last evaluable visit). At endpoint, the percent change in FEV1 was significantly greater (p < 0.01) following treatment with MF-DPI 440 microg (8.9%) than with both BUD-DPI 400 microg (2.1%) and placebo (-3.9%). Secondary efficacy variables, including morning and evening peak expiratory flow rates, albuterol use, percentage of asthma symptom-free days, and physician-evaluated response to therapy were also significantly improved at endpoint in the MF-DPI group compared with both the placebo and BUD-DPI groups (p < 0.05). Both active treatments were well tolerated. In conclusion, once-daily treatment in the morning with MF-DPI 440 microg significantly improved pulmonary function and asthma control compared with morning administration of BUD-DPI 400 microg and placebo.
我们开展本研究,比较每日一次使用干粉吸入器(DPI)给予糠酸莫米松(MF)与每日一次使用布地奈德(BUD)-DPI及安慰剂,在先前每日两次使用吸入性糖皮质激素的中度持续性哮喘患者中的疗效和安全性。在一项为期8周的多中心、安慰剂对照、双盲、双模拟研究中,共有262例(≥12岁)中度持续性哮喘患者被随机分为每日早晨接受一次440微克(计量剂量)的MF-DPI治疗、400微克(计量剂量)的BUD-DPI治疗或安慰剂治疗。主要疗效变量为从基线至终点(最后一次可评估访视)时第一秒用力呼气容积(FEV1)的变化百分比。在终点时,接受440微克MF-DPI治疗后FEV1的变化百分比(8.9%)显著高于接受400微克BUD-DPI治疗(2.1%)和安慰剂治疗(-3.9%)(p<0.01)。与安慰剂组和BUD-DPI组相比,MF-DPI组的次要疗效变量,包括早晚呼气峰值流速、沙丁胺醇使用情况、无哮喘症状天数百分比以及医生评估的治疗反应,在终点时也有显著改善(p<0.05)。两种活性治疗的耐受性均良好。总之,与早晨给予400微克BUD-DPI和安慰剂相比,早晨每日一次使用440微克MF-DPI治疗可显著改善肺功能和哮喘控制情况。