Harnest Ulf, Price David, Howes Tim, Sussman Gordon
Institute for Medical Treatment Strategies, Munich, Germany.
J Asthma. 2008 Apr;45(3):215-20. doi: 10.1080/02770900801890646.
Inhaled corticosteroids (ICSs) are one of the suggested first-line therapies for patients with persistent asthma of moderate severity.
The efficacy and safety of mometasone furoate (MF) 400 microg twice daily (BID) and fluticasone propionate (FP) 500 microg BID administered for 12 weeks via dry powder inhaler (DPI) were compared in a noninferiority trial, in adults with moderate-to-severe persistent asthma. The primary variable was the change from baseline in am peak expiratory flow rate (PEFR). PM PEFR, forced expiratory volume in 1 second (FEV(1)), asthma symptoms, rescue medication use, response to therapy, exacerbation rates, and adverse events were also assessed.
The lower bound of 95% CIs for treatment differences in the primary variable ranged from 2.6% to 5.6% throughout the 12-week study and were within the prespecified noninferiority range. No significant between-group differences were observed in lung function, rescue medication use, response to therapy, exacerbation rates, or adverse events. At most of the weeks assessed, there were no between-group differences in asthma symptoms. Most adverse events were mild-to-moderate.
MF-DPI 400 microg BID was therapeutically equivalent to FP-DPI 500 microg BID in patients with moderate-to-severe persistent asthma.
吸入性糖皮质激素(ICSs)是中度持续性哮喘患者推荐的一线治疗方法之一。
在一项非劣效性试验中,比较了中度至重度持续性哮喘成年患者通过干粉吸入器(DPI)每日两次吸入400微克糠酸莫米松(MF)和每日两次吸入500微克丙酸氟替卡松(FP),持续治疗12周的疗效和安全性。主要变量是上午呼气峰值流速(PEFR)相对于基线的变化。还评估了下午PEFR、一秒用力呼气容积(FEV₁)、哮喘症状、急救药物使用情况、治疗反应、加重率和不良事件。
在整个12周的研究中,主要变量治疗差异的95%置信区间下限在2.6%至5.6%之间,处于预先设定的非劣效性范围内。在肺功能、急救药物使用、治疗反应、加重率或不良事件方面,未观察到显著的组间差异。在大多数评估周,哮喘症状方面也没有组间差异。大多数不良事件为轻度至中度。
对于中度至重度持续性哮喘患者,每日两次吸入400微克MF-DPI与每日两次吸入500微克FP-DPI治疗效果相当。