Zhou Bing, He Gang, Liang Jianping, Cheng Lei, Mehta Anish, Liu Shu, Yu Wenbo, Wang Zaiqi, Han Demin
Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Key Laboratory of Otorhinolaryngology-Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China.
Int Forum Allergy Rhinol. 2016 Jan;6(1):88-94. doi: 10.1002/alr.21650. Epub 2015 Nov 17.
Although mometasone furoate nasal spray (MFNS) has demonstrated efficacy in nasal polyposis (NP) in Western populations, data in Asian populations is limited.
This randomized, double-blind study evaluated MFNS 200 μg twice per day (BID) vs placebo in Chinese adults with bilateral nasal polyps (graded as 1, 2, or 3 by the investigator). A 14-day placebo run-in period was followed by a 16-week treatment period with MFNS 200 μg BID vs placebo (1:1 ratio). The co-primary endpoints were change from baseline in nasal congestion/obstruction averaged over the first 4 weeks of treatment and change from baseline in the total polyp size score (sum of scores from the left and right nasal fossa) at week 16. Secondary endpoints included other sinonasal symptoms scores and safety outcomes such as monitoring laboratory measurements, vital signs, and adverse events (AEs).
There were 748 patients randomized, 375 received MFNS 200 μg BID and 373 received placebo. The between-treatment difference in least squares (LS) mean change from baseline in nasal congestion/obstruction over 4 weeks of treatment was -0.14 (95% confidence interval [CI], -0.22 to -0.06) for MFNS vs placebo (p = 0.0007). The between-treatment difference in LS mean change from baseline in total polyp size score at week 16 was -0.30 (95% CI, -0.45 to -0.15) for MFNS vs placebo (p < 0.0001). Serious AEs were rare (0.5% and 0.8% in MFNS and placebo groups, respectively) and considered not drug-related. There were significantly more AEs of epistaxis with MFNS vs placebo (p = 0.009).
This study demonstrated that MFNS was effective and well tolerated in this population of adult, Chinese patients with NP.
虽然糠酸莫米松鼻喷雾剂(MFNS)在西方人群的鼻息肉(NP)治疗中已显示出疗效,但亚洲人群的数据有限。
这项随机、双盲研究评估了每天两次(BID)使用200μg MFNS与安慰剂对患有双侧鼻息肉(研究者分级为1、2或3级)的中国成年人的疗效。在14天的安慰剂导入期后,进行为期16周的治疗期,比较每天两次使用200μg MFNS与安慰剂(1:1比例)。共同主要终点是治疗前4周平均鼻塞/鼻阻塞相对于基线的变化,以及第16周时息肉总大小评分(左右鼻窝评分总和)相对于基线的变化。次要终点包括其他鼻窦症状评分以及安全性指标,如监测实验室检查结果、生命体征和不良事件(AE)。
共有748例患者被随机分组,375例接受每天两次200μg MFNS治疗,373例接受安慰剂治疗。在治疗4周时,MFNS组与安慰剂组相比,鼻塞/鼻阻塞相对于基线的最小二乘(LS)均值变化的组间差异为-0.14(95%置信区间[CI],-0.22至-0.06)(p = 0.0007)。在第16周时,MFNS组与安慰剂组相比,息肉总大小评分相对于基线的LS均值变化的组间差异为-0.30(95%CI,-0.45至-0.15)(p < 0.0001)。严重不良事件很少见(MFNS组和安慰剂组分别为0.5%和0.8%),且被认为与药物无关。与安慰剂相比,MFNS组鼻出血的不良事件明显更多(p = 0.009)。
本研究表明,MFNS在这群成年中国NP患者中有效且耐受性良好。