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氟替卡松维兰特罗在运动性哮喘青少年中的短期和长期影响:一项随机、开放标签试验。

Short- and long-term effects of fluticasone furoate/vilanterol in exercising asthmatic adolescents: A randomized and open label trial.

机构信息

Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.

Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Basic Clin Pharmacol Toxicol. 2021 Nov;129(5):369-375. doi: 10.1111/bcpt.13640. Epub 2021 Aug 25.

Abstract

PURPOSE

Relvar® (fluticasone furoate [FF]/vilanterol [VI]) is a once-daily inhaler with bronchodilator effect lasting 24 h. Our aim was to investigate the short- and long-term effects of FF/VI on exercise-induced asthma (EIA) in adolescents.

METHODS

Ninety-three adolescent asthmatics aged 12-18 years were referred for evaluation of EIA. Following a positive exercise challenge test (ECT), 22/44 were allocated to a single administration of salbutamol (400 μg) and 22/44 to FF/VI (92/22 μg) in a double-blind method. Thirty-five subjects were reassessed by repeat ECT 30-60 days of FF/VI.

RESULTS

Median FEV change post-ECT at baseline was -22.8% predicted (interquartile range [IQR] -26.1 and -18.0) for salbutamol and -21.0 (IQR -30.7 and -16.8) for FF/VI. Following bronchodilator, FEV improved similarly in both groups. Repeat ECT following 30-60 days of FF/VI resulted in negative ECT in 33/35 subjects; the median decrease in FEV of these 35 subjects was 22.6% predicted (IQR 29-18) before, and 4.6% predicted (IQR 8.7-2.5) after 30-60 days of FF/VI treatment (p < 0.0001).

CONCLUSIONS

FF/VI is effective in reversing EIA after 15 min in adolescents and in protecting EIA after 30-60 days in adolescents. Larger studies are needed to assess the effect of FF/VI on EIA.

摘要

目的

Relvar®(糠酸氟替卡松[FF]/维兰特罗[VI])是一种每日一次的吸入剂,具有持续 24 小时的支气管扩张作用。我们的目的是研究 FF/VI 对青少年运动性哮喘(EIA)的短期和长期影响。

方法

93 名 12-18 岁的青少年哮喘患者因 EIA 评估而就诊。在阳性运动挑战试验(ECT)后,22/44 名患者接受单剂量沙丁胺醇(400μg),22/44 名患者接受 FF/VI(92/22μg),采用双盲法。35 名患者在使用 FF/VI 30-60 天后通过重复 ECT 进行重新评估。

结果

在基线时,沙丁胺醇组 ECT 后中位 FEV 变化为预测值的-22.8%(四分位距[IQR] -26.1 和 -18.0),FF/VI 组为-21.0(IQR -30.7 和 -16.8)。两组在使用支气管扩张剂后,FEV 均有类似改善。在使用 FF/VI 30-60 天后进行重复 ECT,结果显示 35 名患者中有 33 名 ECT 为阴性;这 35 名患者的 FEV 中位数下降了 22.6%(IQR 29-18),而在使用 FF/VI 30-60 天后,FEV 中位数下降了 4.6%(IQR 8.7-2.5)(p<0.0001)。

结论

FF/VI 在青少年中 15 分钟即可有效逆转 EIA,并在青少年中 30-60 天后保护 EIA。需要更大规模的研究来评估 FF/VI 对 EIA 的影响。

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