每日一次低剂量吸入环索奈德对轻至中度哮喘患者的抗炎作用。

Anti-inflammatory effects of once daily low dose inhaled ciclesonide in mild to moderate asthmatic patients.

作者信息

Wilson A M, Duong M, Pratt B, Dolovich M, O'Byrne P M

机构信息

Biomedicine Group, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.

出版信息

Allergy. 2006 May;61(5):537-42. doi: 10.1111/j.1398-9995.2006.01061.x.

DOI:10.1111/j.1398-9995.2006.01061.x

PMID:16629781

Abstract

BACKGROUND

Ciclesonide exhibits clinical efficacy at 160 microg (ex-actuator) once daily but the anti-inflammatory effects at this dose are not known. We wished to know whether 4 weeks therapy with ciclesonide pMDI 160 microg once daily in the morning exhibited significant anti-inflammatory effects.

METHODS

Seventeen patients with mild persistent asthma (FEV(1) 3.35 l) were recruited into a double-blind placebo-controlled randomized crossover study. Measurements were made after ciclesonide and placebo treatment as well as after run-in and washout periods, for adenosine monophosphate (AMP) bronchial challenge (primary variable), exhaled nitric oxide (NO) and induced sputum (in a subgroup).

RESULTS

The mean (SEM) AMP bronchial challenge PC(20) following ciclesonide (140 (63) mg/ml) was significantly (P < 0.001) increased compared with placebo (17 (8) mg/ml), run-in (13 (5) mg/ml) and washout (9 (3) mg/ml) periods. This amounted to an eightfold (CI: 5.3-12.0) for ciclesonide vs placebo. Likewise, there were significant improvements in exhaled NO levels and a significant reduction in induced sputum eosinophil cell counts.

CONCLUSION

We have shown that inhaled ciclesonide given at 160 microg once daily in the morning exhibits significant anti-inflammatory effects that are in keeping with the previously described clinical effects.

摘要

背景

环索奈德每天一次160微克（从吸入装置喷出量）具有临床疗效，但此剂量的抗炎作用尚不清楚。我们想了解每天早晨使用160微克环索奈德压力定量吸入器治疗4周是否具有显著的抗炎作用。

方法

17例轻度持续性哮喘患者（第一秒用力呼气容积[FEV(1)]为3.35升）被纳入一项双盲安慰剂对照随机交叉研究。在环索奈德和安慰剂治疗后以及导入期和洗脱期后进行测量，包括单磷酸腺苷（AMP）支气管激发试验（主要变量）、呼出一氧化氮（NO）和诱导痰（在一个亚组中）。

结果

与安慰剂（17（8）毫克/毫升）、导入期（13（5）毫克/毫升）和洗脱期（9（3）毫克/毫升）相比，环索奈德治疗后（140（63）毫克/毫升）的平均（标准误）AMP支气管激发试验PC(20)显著升高（P<0.001）。环索奈德与安慰剂相比升高了8倍（可信区间：5.3-12.0）。同样，呼出NO水平有显著改善，诱导痰嗜酸性粒细胞计数显著降低。