Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
J Allergy Clin Immunol. 2009 Dec;124(6):1217-21. doi: 10.1016/j.jaci.2009.08.047.
Long-acting ss(2)-agonists are an established controller medication in asthma. BI 1744 is a novel L\long-acting ss(2)-agonist with a preclinical profile that suggests 24-hour bronchodilation and bronchoprotection may be achieved.
To examine the bronchoprotective effects of single doses of BI 1744 against methacholine provocation in subjects with mild asthma.
Thirty-one subjects with mild asthma were randomized to receive single doses of BI 1744 (2, 5, 10, 20 microg) or placebo on separate days according to a double-blind, 5-way crossover design. Methacholine challenges were performed at 30 minutes and at 4, 8, 24, and 32 hours after each single dose of medication, and the results were expressed as PC(20) FEV(1).
All doses of BI 1744 produced statistically significant increases in the methacholine PC(20) compared with placebo as long as 32 hours. The mean (geometric SEM) methacholine PC(20) 24 hours after dosing with placebo was 1.73 (1.13) mg/mL, which increased after 2 microg to 3.86 (1.14) mg/mL, after 5 microg to 5.67 (1.14) mg/mL, after 10 microg to 9.42 (1.13) mg/mL, and after 20 microg to 13.71 (1.14) mg/mL (all P < .0001). After 32 hours, the methacholine PC(20) value remained significantly increased for all doses. No safety or tolerability concerns were identified.
BI 1744 provides significant bronchoprotection against inhaled methacholine for up to 32 hours after single-dose administration.
长效 ss(2)-激动剂是哮喘治疗中一种已确立的控制药物。BI 1744 是一种新型的长效 ss(2)-激动剂,具有临床前特征,提示可能实现 24 小时支气管扩张和支气管保护。
研究单剂量 BI 1744 对轻度哮喘患者乙酰甲胆碱激发的支气管保护作用。
31 例轻度哮喘患者随机分为单剂量 BI 1744(2、5、10、20 微克)或安慰剂,采用双盲、5 路交叉设计。在每次用药后 30 分钟和 4、8、24 和 32 小时进行乙酰甲胆碱挑战,并以 PC(20)FEV(1)表示结果。
所有剂量的 BI 1744 与安慰剂相比,在长达 32 小时的时间内均能显著增加乙酰甲胆碱的 PC(20)。安慰剂给药后 24 小时的平均(几何 SEM)乙酰甲胆碱 PC(20)为 1.73(1.13)mg/mL,2 微克后增加到 3.86(1.14)mg/mL,5 微克后增加到 5.67(1.14)mg/mL,10 微克后增加到 9.42(1.13)mg/mL,20 微克后增加到 13.71(1.14)mg/mL(均 P<.0001)。32 小时后,所有剂量的乙酰甲胆碱 PC(20)值仍显著增加。未发现安全性或耐受性问题。
单剂量 BI 1744 给药后,可显著预防吸入乙酰甲胆碱引起的支气管痉挛,持续时间长达 32 小时。