Nathan R A, Bronsky E A, Fireman P, Grossman J, LaForce C F, Lemanske R F, Pearlman D S, Ratner P H, Rogenes P R
University of Colorado Health Sciences Center, Denver.
Ann Allergy. 1991 Sep;67(3):332-8.
A multicenter double-blind, randomized, parallel group study was conducted to evaluate the once daily administration of fluticasone propionate, a potent, new corticosteroid preparation, for the treatment of seasonal allergic rhinitis. Adult patients (n = 227) were treated for 2 weeks with fluticasone propionate aqueous nasal spray 200 micrograms QD or 100 micrograms BID or matching placebo during the autumn pollen season. Overall, the administration of fluticasone propionate once daily in the morning was as effective as the twice daily dosage regimen, and either regimen was more effective than placebo. Improvement in clinician-rated and patient-rated nasal symptom scores, including morning nasal obstruction, was evident within three days of fluticasone propionate therapy and continued throughout the treatment period. Fewer patients receiving fluticasone propionate used rescue medication and had nasal eosinophilia compared with patients receiving placebo. Adverse events were similar in frequency and nature in all three treatment groups. Morning plasma cortisol concentrations and response to cosyntropin stimulation were similar across groups and offered no evidence of HPA axis suppression. We conclude that fluticasone propionate aqueous nasal spray administered once daily is a safe and effective treatment for seasonal allergic rhinitis. The convenience of a once daily regimen may encourage better compliance.
进行了一项多中心双盲、随机、平行组研究,以评估强效新型皮质类固醇制剂丙酸氟替卡松每日一次给药治疗季节性变应性鼻炎的效果。成年患者(n = 227)在秋季花粉季节用200微克每日一次或100微克每日两次的丙酸氟替卡松水性鼻喷雾剂或匹配的安慰剂治疗2周。总体而言,早晨每日一次给予丙酸氟替卡松与每日两次给药方案效果相同,且两种方案均比安慰剂更有效。在丙酸氟替卡松治疗的三天内,临床医生评估和患者评估的鼻症状评分(包括早晨鼻塞)明显改善,并在整个治疗期间持续改善。与接受安慰剂的患者相比,接受丙酸氟替卡松的患者使用急救药物和出现鼻嗜酸性粒细胞增多的情况较少。所有三个治疗组的不良事件在频率和性质上相似。各组间早晨血浆皮质醇浓度和对促肾上腺皮质激素刺激的反应相似,没有证据表明存在下丘脑-垂体-肾上腺(HPA)轴抑制。我们得出结论,每日一次给予丙酸氟替卡松水性鼻喷雾剂是治疗季节性变应性鼻炎的一种安全有效的方法。每日一次给药方案的便利性可能会鼓励更好的依从性。