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沙美特罗/丙酸氟替卡松吸入剂单药治疗优于布地奈德单药治疗中国成年哮喘患者:一项开放标签、随机、6 周研究。

Salmeterol/Fluticasone Propionate in a Single Inhaler is Superior to Budesonide Alone in Control of Chinese Asthmatic Adults : An Open-Label, Randomised, 6-Week Study.

机构信息

Guangzhou Institute of Respiratory Disease, Guangzhou, China.

出版信息

Clin Drug Investig. 2004;24(10):583-92. doi: 10.2165/00044011-200424100-00004.

Abstract

OBJECTIVE AND DESIGN

There is comparatively little information on asthma management in China. A multicentre, randomised, open-label, parallel-group, 6-week treatment study was conducted to evaluate the efficacy and safety of salmeterol/fluticasone propionate combination treatment in Chinese adult asthmatic patients.

SETTING AND PATIENTS

398 patients with a documented history of moderate-to-severe asthma were randomised to treatment.

INTERVENTIONS

Salmeterol 50mug/fluticasone propionate 100mug twice daily for 6 weeks via Accuhaler((R)) (Diskustrade mark) inhaler and budesonide 400mug twice daily for 6 weeks via Turbuhaler((R)) inhaler.

MAIN OUTCOME MEASURES AND RESULTS

Morning peak expiratory flow (PEF) was investigated as the primary efficacy endpoint; evening PEF, use of salbutamol (albuterol) as rescue medication, and day- and night-time asthma symptom scores were secondary efficacy endpoints. Safety was assessed according to adverse events recorded. Over the 6-week treatment period, salmeterol/fluticasone propionate led to a significantly greater increase in morning (p < 0.0001) and evening (p = 0.0066) PEF compared with budesonide. Moreover, the significant benefit of salmeterol/fluticasone propionate was evident from the first week. Similarly, salmeterol/fluticasone propionate led to significantly greater improvements in the use of rescue medication and day- and night-time asthma symptom scores, compared with budesonide. Both treatments were well tolerated, with a similar incidence (23%) of adverse events in both treatment groups and no serious adverse events.

CONCLUSIONS

Salmeterol/fluticasone propionate 50mug /100mug twice daily was significantly more effective than budesonide 400mug twice daily in improving lung function and reducing symptoms and use of rescue medication in Chinese asthmatic patients who were poorly controlled on low-dose inhaled corticosteroids. This confirms the findings of superior efficacy of this combination product over budesonide in other populations.

摘要

目的和设计

中国关于哮喘管理的信息相对较少。一项多中心、随机、开放标签、平行组、为期 6 周的治疗研究评估了沙美特罗/丙酸氟替卡松联合治疗在中国成年哮喘患者中的疗效和安全性。

设置和患者

398 例有记录的中重度哮喘病史的患者被随机分组进行治疗。

干预措施

沙美特罗 50μg/丙酸氟替卡松 100μg,每日 2 次,通过 Accuhaler((R))(Diskustrade 商标)吸入器;布地奈德 400μg,每日 2 次,通过 Turbuhaler((R))吸入器。

主要观察指标和结果

晨峰呼气流量(PEF)作为主要疗效终点进行研究;晚 PEF、沙丁胺醇(特布他林)的使用作为抢救药物,以及白天和夜间哮喘症状评分作为次要疗效终点。根据记录的不良事件评估安全性。在 6 周的治疗期间,与布地奈德相比,沙美特罗/丙酸氟替卡松显著增加了晨峰(p < 0.0001)和晚峰(p = 0.0066)PEF。此外,从第一周开始,沙美特罗/丙酸氟替卡松的显著益处就显现出来。同样,与布地奈德相比,沙美特罗/丙酸氟替卡松显著改善了抢救药物的使用以及白天和夜间的哮喘症状评分。两种治疗方法均耐受良好,两组治疗的不良事件发生率相似(23%),且无严重不良事件。

结论

与布地奈德相比,沙美特罗/丙酸氟替卡松 50μg/100μg,每日 2 次,显著改善了中国低剂量吸入皮质激素控制不佳的哮喘患者的肺功能,减少了症状和抢救药物的使用。这证实了该联合产品在其他人群中的疗效优于布地奈德。

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