Fukahori Susumu, Kawano Tetsuya, Obase Yasushi, Iriki Jun, Tsuchida-Yabe Tomoko, Tomari Shinya, Fukushima Chizu, Matsuse Hiroto, Mukae Hiroshi
Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Allergy Rhinol (Providence). 2020 Dec 13;11:2152656720980416. doi: 10.1177/2152656720980416. eCollection 2020 Jan-Dec.
For asthma strategy, to avoid the aggravation of bronchial inflammation and contraction, the long acting beta agonist (LABA) addition on inhaled corticosteroids (ICS) has been recommended.
To know whether there is any clinical difference between the additional efficacies of Formoterol (FOR) and Tulobuterol (TUL) onto Budesonide (BUD) may be useful for the elderly patients' asthma treatment strategy.
Eighteen outpatients with mild to moderate bronchial asthma with FEV1.0% < 80% treated by intermediate ICS dosages visited Respiratory Division of Nagasaki University Hospital or Isahaya General Hospital, Japan Community Health care Organization were subjected, and were randomly assigned (9 cases per group) to either the FBC group (BUD/FOR 160/4.5 µg, 2 inhalations twice daily) or BUD + TUL group (BUD 200 mcg: 2 inhalations twice daily + TUL 2 mg daily) and were compared in parallel with 2 arms for 12 weeks prospectively. Peak expiratory flow, forced expiratory volume in 1 second, impulse oscillometry (IOS), fractional exhaled nitric oxide (FeNO), Asthma Control Questionnaire, mini-Asthma Quality of Life Questionnaire (mini-AQLQ), and occurrence of adverse reactions were compared.
The "Fres" of IOS was improved in FBC group (p = 0.03). The "emotion" domain of mini-AQLQ was improved in BUD + TUL group (p = 0.03).
By changing the drug formulation, the patch was superior in terms of satisfaction, but it was thought that the inhaled combination was superior in improving the respiratory function itself. It is necessary to pay attention to the characteristics of the patient when selecting treatment.
对于哮喘治疗策略，为避免支气管炎症和收缩加剧，已推荐在吸入性糖皮质激素（ICS）基础上加用长效β受体激动剂（LABA）。
了解福莫特罗（FOR）和妥洛特罗（TUL）分别加用至布地奈德（BUD）后的额外疗效在老年患者哮喘治疗策略中是否存在临床差异。
18例接受中等剂量ICS治疗、FEV1.0%＜80%的轻至中度支气管哮喘门诊患者就诊于日本长崎大学医院呼吸科或日本社区医疗组织伊佐奈亚综合医院，被随机分组（每组9例），分别进入FBC组（BUD/FOR 160/4.5μg，每日2次，每次2吸）或BUD + TUL组（BUD 200μg：每日2次，每次2吸 + TUL 2mg每日1次），并前瞻性地对两组进行12周的平行比较。比较两组的呼气峰流速、第1秒用力呼气量、脉冲振荡法（IOS）、呼出一氧化氮分数（FeNO）、哮喘控制问卷、哮喘生活质量简易问卷（mini - AQLQ）以及不良反应的发生情况。
FBC组IOS的“Fres”得到改善（p = 0.03）。BUD + TUL组mini - AQLQ的“情绪”领域得到改善（p = 0.03）。
通过改变药物剂型，贴剂在满意度方面更具优势，但吸入联合制剂在改善呼吸功能本身方面更具优势。选择治疗方法时需要关注患者的特点。
