Skura C L, Fowler E G, Wetzel G T, Graves M, Spencer M J
David Geffen School of Medicine at UCLA, 635 Charles Young Drive South, NRB1 Room 401, Los Angeles, CA 90095-7334, USA.
Neurology. 2008 Jan 8;70(2):137-43. doi: 10.1212/01.WNL.0000287070.00149.a9. Epub 2007 Oct 17.
Albuterol is a beta-2 agonist that has been demonstrated to increase muscle strength in studies in animals and humans. Based on a pilot study of extended-release albuterol Repetabs in children with dystrophinopathies, the authors conducted a randomized, double-blind, placebo-controlled study with a crossover design.
Fourteen boys with Duchenne or Becker muscular dystrophy, 6 to 11 years old, completed two treatment periods (albuterol and placebo), 12 weeks each, separated by a 12-week washout period. As the albuterol Repetab formulation was no longer available, an alternate extended release albuterol was used (Volmax, 12 mg per day). Outcome measurements included 1) lean body mass, 2) fat mass, 3) isometric knee extensor and flexor moments, 4) manual muscle testing, and 5) timed functional tests.
Lean body mass was significantly higher for subjects following albuterol treatment compared to placebo treatment, while fat mass was significantly lower. No differences were found in isometric knee moments or manual muscle tests. Time to run/walk 30 feet was improved following albuterol.
Short-term treatment with extended release albuterol may increase lean body mass, decrease fat mass, and improve functional measures in patients with dystrophinopathies. However, the significant change in strength of specific muscle groups found in the pilot study was not observed in the present study. These findings may be attributed to differences in the drug release and kinetics between Repetab and Volmax formulations as they affect the concentration of available beta-2 receptors on the muscle cell surface differently.
沙丁胺醇是一种β-2激动剂,在动物和人体研究中已被证明可增强肌肉力量。基于一项对肌营养不良症患儿使用缓释沙丁胺醇重复片的初步研究,作者进行了一项采用交叉设计的随机、双盲、安慰剂对照研究。
14名6至11岁的杜兴氏或贝克氏肌肉营养不良男孩完成了两个为期12周的治疗期(沙丁胺醇和安慰剂),中间间隔12周的洗脱期。由于不再有沙丁胺醇重复片制剂,使用了另一种缓释沙丁胺醇(沃美克,每日12毫克)。结果测量包括:1)去脂体重,2)脂肪量,3)等长膝关节伸肌和屈肌力矩,4)徒手肌力测试,以及5)定时功能测试。
与安慰剂治疗相比,接受沙丁胺醇治疗的受试者去脂体重显著更高,而脂肪量显著更低。在等长膝关节力矩或徒手肌力测试中未发现差异。沙丁胺醇治疗后,跑/走30英尺的时间有所改善。
缓释沙丁胺醇短期治疗可能会增加肌营养不良症患者的去脂体重,减少脂肪量,并改善功能指标。然而,在本研究中未观察到初步研究中发现的特定肌肉群力量的显著变化。这些发现可能归因于重复片和沃美克制剂之间药物释放和动力学的差异,因为它们对肌肉细胞表面可用β-2受体浓度的影响不同。