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一项随机双盲试验,评估多剂量干粉吸入器递送的丙酸氟替卡松和丙酸氟替卡松/沙美特罗对12岁及以上持续性哮喘患者的疗效和安全性。

Randomized, double-blind trial evaluating the efficacy and safety of fluticasone propionate and fluticasone propionate/salmeterol delivered via multidose dry powder inhalers in patients with persistent asthma aged 12 years and older.

作者信息

Raphael Gordon, Yiu Gloria, Sakov Anat, Liu Siyu, Caracta Cynthia

机构信息

a Bethesda Allergy , Asthma and Research Center , Bethesda , MD , USA.

b Teva Pharmaceuticals , Frazer , PA , USA.

出版信息

J Asthma. 2018 Jun;55(6):640-650. doi: 10.1080/02770903.2017.1350971. Epub 2017 Aug 31.

DOI:10.1080/02770903.2017.1350971
PMID:28763243
Abstract

OBJECTIVE

To assess the efficacy and safety of fluticasone propionate (Fp) and Fp/salmeterol (FS) administered via a novel multidose dry powder inhaler (MDPI) that is easy to use correctly in asthma patients.

METHODS

This phase-3, multicenter, double-blind, parallel-group study evaluated asthmatic patients (≥12 years of age) previously treated with either low- or mid-dose inhaled corticosteroids (ICSs) or ICS/long-acting beta agonists. After a 14- to 21-day run-in, patients were randomized to Fp MDPI 50 mcg, Fp MDPI 100 mcg, FS MDPI 50/12.5 mcg, FS MDPI 100/12.5 mcg, or placebo twice daily for 12 weeks. Change from baseline in forced expiratory volume in 1 second (FEV; primary endpoint) was evaluated at week 12, and serial spirometry was collected at day 1 and week 12 (subset of patients). Safety was assessed by adverse events (AEs).

RESULTS

The full analysis and serial spirometry subset included 640 and 312 patients, respectively. At week 12, FS MDPI significantly improved FEV from baseline at each dose vs corresponding Fp MDPI doses (p < 0.05). Change from baseline in FEV for active treatment groups was significantly greater vs placebo (p < 0.05). After 12 weeks, serial spirometry was significantly greater at all time points in the FS MDPI groups vs corresponding Fp MDPI groups (p < 0.05). Improvements in serial spirometry on day 1 were maintained through week 12. AEs were similar across groups.

CONCLUSIONS

Pulmonary function was significantly improved with Fp MDPI and FS MDPI vs placebo and FS MDPI vs Fp MDPI. Active treatments had a safety profile comparable to placebo.

摘要

目的

评估通过一种新型多剂量干粉吸入器(MDPI)给药的丙酸氟替卡松(Fp)和 Fp/沙美特罗(FS)在哮喘患者中使用的有效性和安全性,该吸入器易于正确使用。

方法

这项 3 期、多中心、双盲、平行组研究评估了先前接受低剂量或中剂量吸入性糖皮质激素(ICS)或 ICS/长效β受体激动剂治疗的哮喘患者(≥12 岁)。经过 14 至 21 天的导入期后,患者被随机分为每日两次接受 Fp MDPI 50 微克、Fp MDPI 100 微克、FS MDPI 50/12.5 微克、FS MDPI 100/12.5 微克或安慰剂治疗,为期 12 周。在第 12 周评估 1 秒用力呼气量(FEV;主要终点)相对于基线的变化,并在第 1 天和第 12 周收集连续肺功能测定数据(患者子集)。通过不良事件(AE)评估安全性。

结果

完整分析和连续肺功能测定子集分别包括 640 名和 312 名患者。在第 12 周时,与相应的 Fp MDPI 剂量相比,各剂量的 FS MDPI 均使 FEV 相对于基线有显著改善(p < 0.05)。活性治疗组的 FEV 相对于基线的变化显著大于安慰剂组(p < 0.05)。12 周后,FS MDPI 组在所有时间点的连续肺功能测定数据均显著高于相应的 Fp MDPI 组(p < 0.05)。第 1 天的连续肺功能测定改善情况在第 12 周时得以维持。各组的不良事件相似。

结论

与安慰剂相比,Fp MDPI 和 FS MDPI 显著改善了肺功能,且 FS MDPI 相对于 Fp MDPI 也有改善。活性治疗的安全性与安慰剂相当。

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