Calverley Peter M A, Rennard Stephen, Nelson Harold S, Karpel Jill P, Abbate Eduardo H, Stryszak Paul, Staudinger Heribert
Department of Medicine, University Hospital Aintree, Liverpool, UK.
Respir Res. 2008 Nov 13;9(1):73. doi: 10.1186/1465-9921-9-73.
Many patients with chronic obstructive pulmonary disease (COPD) are treated with twice daily (BID) inhaled corticosteroids (ICS). This study evaluated whether daily PM mometasone furoate administered via a dry powder inhaler (MF-DPI) was equally effective compared to twice daily dosing.In a 52-week, randomized, double-blind, placebo-controlled study, 911 subjects with moderate-to-severe COPD managed without ICS received MF-DPI 800 microg QD PM, MF-DPI 400 microg BID, or placebo. The change from baseline in postbronchodilator forced expiratory volume in 1 second (FEV1), total COPD symptom scores, and health status as well as the percentage of subjects with a COPD exacerbation were assessed. Adverse events were recorded. Mometasone furoate administered via a dry powder inhaler 800 microg QD PM and 400 microg BID significantly increased postbronchodilator FEV1 from baseline (50 mL and 53 mL, respectively, versus a 19 mL decrease for placebo; P < 0.001). The percentage of subjects exacerbating was significantly lower in the pooled MF-DPI groups than in the placebo group (P = 0.043). Subjects receiving MF-DPI 400 microg BID reported a statistically significant (19%) reduction in COPD symptom scores compared with placebo (P < 0.001). Health status as measured with St. George's Respiratory Questionnaire (SGRQ) improved significantly in all domains (Total, Activity, Impacts, and Symptoms) in the pooled MF-DPI groups versus placebo (P < or = 0.031). MF-DPI treatment was well tolerated.Once-daily MF-DPI improved lung function and health status in subjects with moderate-to-severe COPD and was comparable to BID MF-DPI.
许多慢性阻塞性肺疾病(COPD)患者接受每日两次(BID)吸入性糖皮质激素(ICS)治疗。本研究评估了通过干粉吸入器(MF-DPI)每日一次给药的糠酸莫米松与每日两次给药相比是否具有同等疗效。在一项为期52周的随机、双盲、安慰剂对照研究中,911例未使用ICS治疗的中重度COPD患者接受了每日一次800微克的MF-DPI、每日两次400微克的MF-DPI或安慰剂治疗。评估了支气管扩张剂后1秒用力呼气容积(FEV1)相对于基线的变化、COPD总症状评分、健康状况以及COPD急性加重患者的百分比。记录不良事件。通过干粉吸入器每日一次800微克和每日两次400微克给药的糠酸莫米松使支气管扩张剂后的FEV1相对于基线显著增加(分别增加50毫升和53毫升,而安慰剂组下降19毫升;P<0.001)。联合MF-DPI组的急性加重患者百分比显著低于安慰剂组(P = 0.043)。与安慰剂相比,接受每日两次400微克MF-DPI治疗的患者报告COPD症状评分有统计学意义的降低(19%)(P<0.001)。与安慰剂相比,联合MF-DPI组使用圣乔治呼吸问卷(SGRQ)测量的健康状况在所有领域(总分、活动、影响和症状)均有显著改善(P≤0.031)。MF-DPI治疗耐受性良好。每日一次的MF-DPI改善了中重度COPD患者的肺功能和健康状况,且与每日两次给药的MF-DPI相当。