Aierken Aibibai, Yu Su Fu Bu Wei Mai Erye Mu, Xu Peiru
Department of Pediatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China.
Department of Pediatrics, The First People's Hospital of Kashi, Kashi, Xinjiang Uygur Autonomous Region 844000, P.R. China.
Exp Ther Med. 2022 Jul 19;24(3):577. doi: 10.3892/etm.2022.11514. eCollection 2022 Sep.
Children aged 6-11 years with uncontrolled asthma are treated with low-dose inhaled corticosteroid (ICS) with stepwise increase in ICS dosage and/or add-on maintenance treatment, as necessary. The objective of the present study was to evaluate the efficacy and safety of tiotropium add-on treatment in children with severe and mild symptomatic asthma. The present prospective cohort study included 144 children with severe and mild asthma (age, 6-11 years) who received ICS (budesonide) with ≥1 controller treatment combination therapies for ≥1 month and score ≥1.5 based on Asthma Control Questionnaire-Interviewer-Administered. In addition to ICS with ≥1 controller treatment, children received 5 µg once-daily tiotropium (treatment group; n=72) or did not receive tiotropium (control group; n=72). The peak forced expiratory volume in 1-sec change from the baseline 3 h post-administration of tiotropium was significantly improved in the treatment group compared with the control group (384±31 vs. 248±28 ml; P<0.0001). The trough forced expiratory volume in 1-sec (224±28 vs. 140±31 ml; P<0.0001) and forced expiratory flow at 25-75% of forced vital capacity (389±36 vs. 116±27 ml/sec; P<0.0001) showed significant improvement following treatment with tiotropium. Significant differences were noted for trough forced vital capacity (153±29 vs. 139±30 ml/sec; P<0.0001), mean weekly rescue treatment usage (0.29±0.08 vs. 0.36±0.09; P<0.0001), mean weekly peak expiratory flow measurement (4.12±3.56 vs. 7.46±3.29 l/min; P<0.0001) and mean weekly symptom-free time (0.19±0.04 vs. 0.16±0.04 days; P<0.0001) between both cohorts. Children of both groups tolerated any adverse effects. Tiotropium 5 µg administered once/day as an add-on treatment to ICS with ≥1 controller treatments in children (6-11 years of age) with severe and mild symptomatic asthma was found to be efficacious and safe (level of evidence 2; technical efficacy stage 4).
6至11岁未得到有效控制的哮喘儿童，必要时采用低剂量吸入性糖皮质激素（ICS）治疗，并逐步增加ICS剂量和/或添加维持治疗。本研究的目的是评估噻托溴铵添加治疗对重度和轻度症状性哮喘儿童的疗效和安全性。本前瞻性队列研究纳入了144例重度和轻度哮喘儿童（年龄6至11岁），这些儿童接受ICS（布地奈德）联合≥1种控制治疗组合疗法≥1个月，且根据哮喘控制问卷-访谈者管理版评分≥1.5。除了ICS联合≥1种控制治疗外，儿童接受每日一次5μg噻托溴铵治疗（治疗组；n = 72）或不接受噻托溴铵治疗（对照组；n = 72）。与对照组相比，治疗组在给予噻托溴铵后3小时，1秒用力呼气容积峰值较基线的变化显著改善（384±31 vs. 248±28 ml；P<0.0001）。1秒用力呼气容积谷值（224±28 vs. 140±31 ml；P<0.0001）和用力肺活量25%-75%时的用力呼气流量（389±36 vs. 116±27 ml/秒；P<0.0001）在接受噻托溴铵治疗后显示出显著改善。两组在用力肺活量谷值（153±29 vs. 139±30 ml/秒；P<0.0001）、平均每周急救治疗使用次数（0.29±0.08 vs. 0.36±0.09；P<0.0001）、平均每周呼气峰值流速测量值（4.12±3.56 vs. 7.46±3.29 l/分钟；P<0.0001）和平均每周无症状时间（0.19±0.04 vs. 0.16±0.04天；P<0.0001）方面存在显著差异。两组儿童对任何不良反应均耐受。对于6至11岁患有重度和轻度症状性哮喘的儿童，每日一次给予5μg噻托溴铵作为ICS联合≥1种控制治疗的添加治疗，被发现是有效且安全的（证据级别2；技术疗效阶段4）。
