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细菌溶解产物OM-85治疗单纯性急性呼吸道感染的疗效和安全性:一项双盲、安慰剂对照、多中心、随机试验

[Efficacy and safety of bacterial lysate OM-85 in the treatment of uncomplicated acute respiratory infections: a double-blind, placebo-controlled, multicenter, randomized trial].

作者信息

Kalyuzhin O V, Gorelov A V, Malyavin A G, Zaytsev A A, Esaulenko E V, Novak K E, Bykov A S

机构信息

Sechenov First Moscow State Medical University (Sechenov University).

Central Research Institute of Epidemiology.

出版信息

Ter Arkh. 2023 Nov 23;95(10):850-858. doi: 10.26442/00403660.2023.10.202464.

Abstract

AIM

To evaluate the efficacy and safety of OM-85 in the treatment of uncomplicated acute respiratory infections (ARI) in adults.

MATERIALS AND METHODS

A double-blind, placebo-controlled, multicenter, randomized trial included 556 patients (18-60 years old) with mild and moderate ARI and negative results of polymerase chain reaction analysis for SARS-CoV-2 RNA and rapid test for influenza A and B viruses. Patients were randomized into two groups: in the first group (278), patients received OM-85 (Broncho-munal) one capsule 7 mg/day for 10 days, while the second group (278) was treated with placebo in the same regimen. The primary endpoint was the dynamics of the severity of symptoms over 3, 5, 7 and 10 days of treatment according to the 21-item Wisconsin Upper Respiratory Symptom Survey (WURSS-21), which was assessed by the area under the curve. Secondary efficacy criteria were the dynamics of the severity of symptoms according to the Common Cold Questionnaire (CCQ), the time to the resolution of symptoms according to WURSS-21 and CCQ, the proportion of patients with body temperature below 37°C on each day of treatment, frequency of the need for systemic antibacterial therapy.

RESULTS

The superiority of OM-85 over placebo by primary endpoint was observed on the 5th, 7th and 10th days of treatment. OM-85 efficacy has also been proven by secondary criteria. OM-85 shortened the time until the symptoms of ARI resolved according to the WURSS-21 and CCQ, increased the proportion of patients with body temperature below 37°C by 2-9 days. The time needed to resolve the symptoms of disease in 20% of patients according to WURSS-21 was 7 and 9 days in patients taking OM-85 and placebo, respectively. Bacterial lysate increased the probability of complete disappearance of symptoms according to CCQ by 45.7% compared to placebo. The analysis of the frequency and severity of adverse events, laboratory tests, physical and instrumental examination results during treatment confirmed the good tolerability and safety of OM-85.

CONCLUSION

The study confirmed the efficacy and safety of OM-85 in the complex treatment of ARI in adults.

摘要

目的

评估OM-85治疗成人单纯性急性呼吸道感染(ARI)的疗效和安全性。

材料与方法

一项双盲、安慰剂对照、多中心随机试验纳入了556例年龄在18至60岁之间的轻度和中度ARI患者,这些患者的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)RNA聚合酶链反应分析结果及甲型和乙型流感病毒快速检测结果均为阴性。患者被随机分为两组:第一组(278例)患者接受OM-85(泛福舒),每日1粒7毫克,共服用10天;而第二组(278例)则采用相同疗程的安慰剂治疗。主要终点是根据21项威斯康星上呼吸道症状调查问卷(WURSS-21)评估治疗3、5、7和10天时症状严重程度的动态变化,通过曲线下面积进行评估。次要疗效标准包括根据普通感冒问卷(CCQ)评估的症状严重程度动态变化、根据WURSS-21和CCQ评估的症状缓解时间、治疗期间每天体温低于37°C的患者比例、全身抗菌治疗的需求频率。

结果

在治疗的第5、7和10天观察到OM-85在主要终点方面优于安慰剂。次要标准也证明了OM-85的疗效。OM-85缩短了根据WURSS-21和CCQ评估的ARI症状缓解时间,使体温低于37°C的患者比例在2至9天内有所增加。根据WURSS-21,服用OM-85和安慰剂的患者中,20%的患者症状缓解所需时间分别为7天和9天。与安慰剂相比,细菌溶解产物使根据CCQ评估的症状完全消失的概率提高了45.7%。对治疗期间不良事件的频率和严重程度、实验室检查、体格检查和器械检查结果的分析证实了OM-85具有良好的耐受性和安全性。

结论

该研究证实了OM-85在成人ARI综合治疗中的疗效和安全性。

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