Gelfand Erwin W, Georgitis John W, Noonan Michael, Ruff Michael E
Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA.
J Pediatr. 2006 Mar;148(3):377-83. doi: 10.1016/j.jpeds.2005.10.028.
To compare the efficacy and safety of once-daily inhaled ciclesonide 40 mug (CIC40), 80 mug (CIC80), and 160 mug (CIC160) with placebo in children with persistent asthma of all severities.
Overall, 1031 children age 4 to 11 years were randomized into 2 identical double-blinded, placebo-controlled, parallel group studies consisting of a run-in phase followed by 12 weeks of treatment. Both studies were designed to allow for a prespecified integrated analysis. The primary outcome variable was change in forced expiratory volume in 1 second (FEV(1)) percent predicted between baseline and study end; treatment comparisons were assessed using analysis of covariance. Additional endpoints included asthma symptom scores, daily albuterol use, and safety, including hypothalamic-pituitary-adrenal (HPA) axis function.
Baseline characteristics were comparable; 59.4% of patients had moderate asthma, and 24.1% had severe asthma. All ciclesonide doses were associated with greater improvements in baseline to week 12 FEV(1) percent predicted versus placebo (CIC40, 11.97; CIC80, 13.58, P <.05; CIC160, 14.17, P < .01). Significant improvements in asthma symptoms (P < .01) and reductions in albuterol use were reported. Ciclesonide was well tolerated with no effect on HPA axis function.
In this integrated analysis, ciclesonide was effective and well tolerated in children with persistent asthma.
比较每日一次吸入40微克(CIC40)、80微克(CIC80)和160微克(CIC160)环索奈德与安慰剂对所有严重程度持续性哮喘儿童的疗效和安全性。
总体而言,1031名4至11岁儿童被随机分为2项相同的双盲、安慰剂对照、平行组研究,包括导入期,随后是12周的治疗。两项研究均设计为允许进行预先指定的综合分析。主要结局变量是基线至研究结束时1秒用力呼气量(FEV(1))预测值的变化;使用协方差分析评估治疗组间差异。其他终点包括哮喘症状评分、每日沙丁胺醇使用情况以及安全性,包括下丘脑 - 垂体 - 肾上腺(HPA)轴功能。
基线特征具有可比性;59.4%的患者患有中度哮喘,24.1%患有重度哮喘。与安慰剂相比,所有环索奈德剂量在基线至第12周FEV(1)预测值方面均有更大改善(CIC40为11.97;CIC80为13.58,P <.05;CIC160为14.17,P <.01)。哮喘症状有显著改善(P <.01),沙丁胺醇使用量减少。环索奈德耐受性良好,对HPA轴功能无影响。
在这项综合分析中,环索奈德对持续性哮喘儿童有效且耐受性良好。