Qaqundah Paul Y, Sugerman Robert W, Ceruti Elaina, Maspero Jorge Fernando, Kleha Joseph F, Scott Catherine A, Wu Wei, Mehta Rashmi, Crim Courtney
Pediatric Medical Care Group, Inc, Huntington Beach, CA, USA.
J Pediatr. 2006 Nov;149(5):663-670. doi: 10.1016/j.jpeds.2006.07.045.
To evaluate the efficacy and tolerability of fluticasone propionate (FP) hydrofluoroalkane (HFA) in children age 1 to < 4 years with asthma.
Children were assigned (2:1) to receive FP HFA 88 mug (n = 239) or placebo HFA (n = 120) twice daily through a metered-dose inhaler with a valved holding chamber and attached facemask for 12 weeks. The primary efficacy measure was mean percent change from baseline to endpoint in 24-hour daily (composite of daytime and nighttime) asthma symptom scores.
The FP-treated children had significantly greater (P < or = .05) reductions in 24-hour daily asthma symptom scores (-53.9% vs -44.1%) and nighttime symptom scores over the entire treatment period compared with the placebo group. Daytime asthma symptom scores and albuterol use were slightly more decreased with FP than with placebo; however, the differences were not statistically significant. Increases in the percentage of symptom-free days were comparable. The percentage of patients who experienced at least 1 adverse event was similar in the 2 groups. Baseline median urinary cortisol excretion values were comparable between the groups, and there was little change from baseline at endpoint. FP plasma concentrations demonstrated that systemic exposure was low.
FP HFA 88 mug twice daily was effective and well tolerated in pre-school-age children with asthma.
评估丙酸氟替卡松(FP)氢氟烷烃(HFA)对1至<4岁哮喘儿童的疗效和耐受性。
将儿童按2:1分配,通过带有带阀储物罐和面罩的定量吸入器,每日两次接受88微克FP HFA(n = 239)或安慰剂HFA(n = 120),为期12周。主要疗效指标是24小时每日(白天和夜间综合)哮喘症状评分从基线到终点的平均变化百分比。
与安慰剂组相比,接受FP治疗的儿童在整个治疗期间24小时每日哮喘症状评分(-53.9%对-44.1%)和夜间症状评分的降低幅度显著更大(P≤0.05)。与安慰剂相比,FP使白天哮喘症状评分和沙丁胺醇使用量的降低幅度略大;然而,差异无统计学意义。无症状天数的增加幅度相当。两组中至少经历1次不良事件的患者百分比相似。两组间基线尿皮质醇排泄中位数可比,终点时与基线相比变化不大。FP血浆浓度表明全身暴露较低。
每日两次88微克FP HFA对学龄前哮喘儿童有效且耐受性良好。