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糠酸莫米松干粉吸入器与丙酸氟替卡松定量气雾剂用于曾使用丙酸氟替卡松的哮喘患者的疗效及安全性比较

Efficacy and safety of mometasone furoate dry powder inhaler vs fluticasone propionate metered-dose inhaler in asthma subjects previously using fluticasone propionate.

作者信息

Wardlaw Andy, Larivee Pierre, Eller Jorg, Cockcroft Donald W, Ghaly Lisa, Harris Alan G

机构信息

Institute for Lung Health, Glenfield Hospital NHS Trust, Leicester, England.

出版信息

Ann Allergy Asthma Immunol. 2004 Jul;93(1):49-55. doi: 10.1016/S1081-1206(10)61446-9.

Abstract

OBJECTIVE

To compare the efficacy and safety of mometasone furoate dry powder inhaler (DPI) administered once daily in the evening with fluticasone propionate metered-dose inhaler (MDI) administered twice daily.

METHODS

An 8-week, randomized, open-label, parallel-group study compared mometasone furoate DPI, 400 microg every evening (1 puff daily), with fluticasone propionate MDI, two 125-microg puffs twice daily, in 167 adults and adolescents with moderate persistent asthma previously using fluticasone propionate. The primary efficacy variable was the change in forced expiratory volume in 1 second (FEV1) from baseline to the end point. Variables such as response to therapy and subject satisfaction with the inhaler devices were also analyzed.

RESULTS

Improvement in FEV1 was noted at the week 2 visit with both treatments. This improvement was maintained at the 4- and 8-week visits and at the end point for both groups. The mean percent change in FEV1 from baseline to the end point was 4.58% with mometasone furoate DPI and 6.98% with fluticasone propionate MDI (P = .35). At the end point, physicians rated 62% of the mometasone furoate DPI group as "improved" or "much improved" compared with 47% of the fluticasone propionate MDI group (P = .007). A significantly greater proportion of subjects in the mometasone furoate DPI group "liked the inhaler a lot" vs subjects in the fluticasone propionate MDI group (46.8% vs 22.4%; P = .01). Both treatments were well tolerated.

CONCLUSION

Mometasone furoate DPI, 400 microg every evening, provided comparable efficacy as fluticasone propionate MDI, two 125-microg puffs twice daily, in subjects with moderate persistent asthma previously treated with fluticasone propionate.

摘要

目的

比较糠酸莫米松干粉吸入器(DPI)每晚给药一次与丙酸氟替卡松定量气雾剂(MDI)每日给药两次的疗效和安全性。

方法

一项为期8周的随机、开放标签、平行组研究,比较了167名曾使用丙酸氟替卡松的中度持续性哮喘成人和青少年患者,每晚使用400微克糠酸莫米松DPI(每日1吸)与每日两次使用两次125微克丙酸氟替卡松MDI的情况。主要疗效变量是从基线到终点的1秒用力呼气容积(FEV1)变化。还分析了诸如治疗反应和受试者对吸入装置的满意度等变量。

结果

两种治疗在第2周就诊时均观察到FEV1有所改善。这种改善在第4周和第8周就诊时以及两组的终点时均得以维持。从基线到终点,糠酸莫米松DPI组FEV1的平均百分比变化为4.58%,丙酸氟替卡松MDI组为6.98%(P = 0.35)。在终点时,医生将62%的糠酸莫米松DPI组患者评为“改善”或“显著改善”,而丙酸氟替卡松MDI组为47%(P = 0.007)。与丙酸氟替卡松MDI组相比,糠酸莫米松DPI组中“非常喜欢吸入器”的受试者比例显著更高(46.8%对22.4%;P = 0.01)。两种治疗的耐受性均良好。

结论

对于曾用丙酸氟替卡松治疗的中度持续性哮喘患者,每晚使用400微克糠酸莫米松DPI与每日两次使用两次125微克丙酸氟替卡松MDI的疗效相当。

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