Allergy and Asthma Specialists Medical Group, Huntington Beach, Californai 92647, USA.
Allergy Asthma Proc. 2010 Jul-Aug;31(4):280-9. doi: 10.2500/aap.2010.31.3381. Epub 2010 Aug 3.
A significant unmet medical need exists in patients with uncontrolled asthma. The purpose of this study was to evaluate the efficacy and safety of mometasone furoate/formoterol (MF/F) 400/10 microg versus MF 400 microg administered twice-daily (b.i.d.) via metered-dose inhaler in patients with asthma uncontrolled on high-dose inhaled corticosteroids (ICS). In a 12-week, randomized, multicenter, double-blind, parallel-group study, patients (>or=12 years of age) were randomized to MF/F 200/10 microg, MF/F 400/10 microg, or MF 400 microg, b.i.d. after a 2- to 3-week open-label run in with MF 400 microg b.i.d. The primary end point was mean change in area under the curve from 0 to 12 hours in forced expiratory volume in 1 second (FEV(1) AUC(0-12h)) from baseline to week 12 for MF/F 400/10 microg versus MF 400 microg. Effects of MF/F on asthma control and symptoms were evaluated and adverse events recorded. Seven hundred twenty-eight patients were randomized. Significant improvement from baseline to week 12 occurred for mean change in FEV(1) AUC(0-12h) with MF/F 400/10 microg (4.19 L x hour) versus MF 400 microg (2.04 L x hour; p < 0.001). Both MF/F doses resulted in rapid (5 minutes) and sustained improvement in lung function throughout 12 weeks. Both MF/F doses were superior to MF in improving asthma control and reducing nocturnal awakenings due to asthma requiring short-acting beta(2)-agonist use. All treatments were well tolerated. Asthma patients who were poorly controlled on high-dose ICS experienced significant improvement in asthma control, lung function, and symptoms when treated with MF/F compared with MF.
在未得到控制的哮喘患者中存在重大的未满足的医疗需求。本研究的目的是评估莫米松糠酸酯/福莫特罗(MF/F)400/10μg与每日两次(bid)通过计量吸入器给予的 MF 400μg在高剂量吸入皮质类固醇(ICS)控制不佳的哮喘患者中的疗效和安全性。在一项为期 12 周、随机、多中心、双盲、平行分组的研究中,患者(≥12 岁)在 2-3 周的 MF 400μg bid 开放性试验后随机分配至 MF/F 200/10μg、MF/F 400/10μg 或 MF 400μg bid。主要终点是 MF/F 400/10μg与 MF 400μg相比,从基线到第 12 周时 1 秒用力呼气容积(FEV1)曲线下面积(0-12 小时)(FEV1AUC(0-12h))的平均变化。评估了 MF/F 对哮喘控制和症状的影响,并记录了不良事件。728 名患者被随机分组。MF/F 400/10μg(4.19 L×小时)与 MF 400μg(2.04 L×小时)相比,FEV1AUC(0-12h)的平均变化从基线到第 12 周显著改善(p<0.001)。MF/F 两种剂量均能在 12 周内迅速(5 分钟)和持续改善肺功能。MF/F 两种剂量在改善哮喘控制和减少因哮喘需要使用短效β2-激动剂而导致的夜间觉醒方面均优于 MF。所有治疗均耐受良好。与 MF 相比,高剂量 ICS 控制不佳的哮喘患者在接受 MF/F 治疗后哮喘控制、肺功能和症状均显著改善。