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中重度哮喘患者中氟替卡松/福莫特罗联合治疗的疗效和安全性。

Efficacy and safety of fluticasone/formoterol combination therapy in patients with moderate-to-severe asthma.

机构信息

Allergy Medical Clinic, 10780 Santa Monica Blvd., Suite 280, Los Angeles, CA 90025, USA.

出版信息

Respir Med. 2013 Feb;107(2):180-95. doi: 10.1016/j.rmed.2012.10.025. Epub 2012 Dec 25.

Abstract

BACKGROUND

The inhaled corticosteroid, fluticasone propionate, and the long-acting β(2)-adrenergic agonist, formoterol fumarate, are both highly effective treatments for bronchial asthma. This study (NCT00393952/EudraCT number: 2006-005989-39) compared the efficacy and safety of fluticasone/formoterol combination therapy (flutiform(®); 250/10 μg) administered twice daily (b.i.d.) via a single aerosol inhaler, with the individual components (fluticasone 250 μg b.i.d.; formoterol 10 μg b.i.d.), in adult and adolescent patients with moderate-to-severe asthma.

METHODS

This was a 12-week, double-blind, randomised, parallel-group, multicentre, placebocontrolled phase 3 study. The co-primary efficacy endpoints were: i) the mean change in the forced expiratory volume in the first second (FEV(1)) from morning pre-dose at baseline to pre-dose at week 12 (fluticasone/formoterol 250/10 μg vs. formoterol), ii) the mean change in FEV(1) from morning pre-dose at baseline to 2 h post-dose at week 12 (fluticasone/formoterol 250/10 μg vs. fluticasone), and iii) the number of patients who discontinued prematurely due to lack of treatment efficacy (fluticasone/formoterol 250/10 μg vs. placebo). The secondary endpoints included measures of lung function, disease control, and asthma symptoms. Safety was assessed based on adverse events, vital signs, and clinical laboratory evaluations.

RESULTS

Overall, 395 (70.9%) patients completed the study. Fluticasone/formoterol 250/10 μg b.i.d. was superior to the individual components and placebo for all three co-primary endpoints and demonstrated numerically greater improvements for multiple secondary efficacy analyses. Fluticasone/formoterol combination therapy had a good safety profile over the 12 weeks.

CONCLUSION

Fluticasone/formoterol combination therapy will provide clinicians with an efficacious alternative treatment option for patients with moderate-to-severe asthma.

摘要

背景

吸入性皮质类固醇药物丙酸氟替卡松和长效β2-激动剂富马酸福莫特罗均为治疗支气管哮喘的高效药物。本研究(NCT00393952/EudraCT 编号:2006-005989-39)比较了每日两次(bid)经单剂量气雾剂吸入给药的丙酸氟替卡松/福莫特罗复方制剂(氟替卡松/福莫特罗,250/10μg)与两种单药成分(丙酸氟替卡松 250μg bid;福莫特罗 10μg bid)治疗中重度哮喘成年和青少年患者的疗效和安全性。

方法

这是一项为期 12 周、双盲、随机、平行分组、多中心、安慰剂对照的 3 期研究。主要疗效终点包括:i)从基线时早晨预用药至第 12 周预用药时第一秒用力呼气容积(FEV1)的平均变化(氟替卡松/福莫特罗 250/10μg 与福莫特罗相比),ii)从基线时早晨预用药至第 12 周 2 小时后用药时 FEV1 的平均变化(氟替卡松/福莫特罗 250/10μg 与氟替卡松相比),以及 iii)因治疗效果不佳而提前停药的患者人数(氟替卡松/福莫特罗 250/10μg 与安慰剂相比)。次要终点包括肺功能、疾病控制和哮喘症状的测量。安全性基于不良事件、生命体征和临床实验室评估。

结果

共有 395 名(70.9%)患者完成了研究。氟替卡松/福莫特罗 250/10μg bid 在所有三个主要疗效终点均优于单药成分和安慰剂,并且在多项次要疗效分析中表现出更大的改善。氟替卡松/福莫特罗联合治疗在 12 周内具有良好的安全性。

结论

氟替卡松/福莫特罗联合治疗将为中重度哮喘患者提供一种有效的替代治疗选择。

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