Murray John J, Waitkus-Edwards Kelli R, Yancey Steven W
Internal Medicine, Meharry Medical College, Nashville, TN, USA.
Open Respir Med J. 2011;5:11-8. doi: 10.2174/1874306401105010011. Epub 2011 Apr 15.
This study was designed to demonstrate that four weeks of fluticasone propionate (FP) 100 micrograms (mcg) combined with salmeterol 50 mcg twice daily (BID) via DISKUS(®) resulted in protection against bronchospasm induced by activity, as measured by standardized exercise challenge testing in pediatric and adolescent subjects who required regular use of inhaled corticosteroids for the treatment of persistent asthma.
Prior to study entry, all patients reported regular use of inhaled corticosteroids (ICS). During screening all patients demonstrated ≥20% fall in FEV(1) following exercise.
A total of 231 subjects aged 4 to 17 were randomized to the two study treatments: 113 to the FP/salmeterol combination group (FSC) and 118 to receive FP 100 mcg BID. Of the subjects randomized, 106 (94%) subjects in the FSC 100/50 group and 108 (92%) subjects in the FP 100 group completed the study. At the end of treatment (Week 4), both FSC and FP protected against a fall in FEV(1) following exercise in patients who at baseline experienced ≥20% fall in FEV(1) following exercise. A mean decrease in FEV(1) of 9.9% was observed in the FSC 100/50 group as compared with a mean decrease of 11.1% in the FP 100 group; there was no statistical difference between treatments.
Both FSC 100/50 and FP 100 provided protection against an exercised-induced fall in FEV(1); but statistically significant differences we not noted. Both treatments were well-tolerated over four weeks and FSC 100/50 had an adverse event profile comparable to that observed with FP 100.
本研究旨在证明,对于需要定期使用吸入性糖皮质激素治疗持续性哮喘的儿童和青少年受试者,通过都保(DISKUS®)装置每日两次吸入100微克丙酸氟替卡松(FP)联合50微克沙美特罗,持续四周,可预防因活动诱发的支气管痉挛,这一效果通过标准化运动激发试验来衡量。
在研究开始前,所有患者均报告定期使用吸入性糖皮质激素(ICS)。在筛查期间,所有患者在运动后FEV₁下降≥20%。
共有231名4至17岁的受试者被随机分配至两种研究治疗组:113名进入FP/沙美特罗联合治疗组(FSC),118名接受每日两次100微克FP治疗。在随机分组的受试者中,FSC 100/50组的106名(94%)受试者和FP 100组的108名(92%)受试者完成了研究。在治疗结束时(第4周),FSC和FP均可预防基线运动后FEV₁下降≥20%的患者运动后FEV₁下降。FSC 100/50组FEV₁平均下降9.9%,而FP 100组平均下降11.1%;两组治疗之间无统计学差异。
FSC 100/50和FP 100均可预防运动诱发的FEV₁下降;但未观察到统计学上的显著差异。两种治疗在四周内耐受性良好,FSC 100/50的不良事件情况与FP 100相当。