Ramsdell J W, Fish L, Graft D, Higgins N, Kavuru M, Pleskow W, Banerji D
University of California-San Diego, 92103-8415, USA.
Ann Allergy Asthma Immunol. 1998 May;80(5):385-90. doi: 10.1016/S1081-1206(10)62988-2.
National and international guidelines recommend inhaled anti-inflammatory medications for patients with all but the mildest forms of asthma. Patients may also be more compliant with twice daily dosing.
To evaluate the efficacy and safety of triamcinolone acetonide (triamcinolone acetonide), 400 microg bid, in mild-to-moderate asthma patients.
A multicenter, randomized, double-blind, placebo-controlled study with a 7- to 21-day baseline and 6-week treatment period. Adult mild-to-moderate asthma patients poorly controlled by beta2-agonists alone were randomized to receive placebo (48) or triamcinolone acetonide (53). Patients recorded daytime and nighttime asthma symptoms, albuterol use, and morning and evening peak expiratory flow (PEF) rates on diary cards. Clinic spirometry measures included FEV1, FEF25-75%, FVC, FEV1/FVC, and PEF.
Triamcinolone acetonide treatment resulted in improvement from baseline of 17% for FEV1 (P < .0001); 44% for albuterol use (P = .0009); 9% for FVC (P = .0185); 19% for PEF (P = .0011); 42% for FEF25-75% (P < .0001); 8% for FEV1/FVC (P = .0016); 36% for daytime, 39% for nighttime, and 38% for total asthma symptoms (P < or = .0001); and 12% for morning, and 10% for evening PEF (P < or = .001). These changes were highly significant when compared with placebo (P < or = .0185). Significant improvement for all variables was demonstrated within 1 to 2 weeks of active treatment, and maintained for most variables over the 6-week treatment phase. Both treatments were well tolerated. Respiratory adverse events occurred more frequently with placebo; pharyngitis was reported more frequently with triamcinolone acetonide.
Triamcinolone acetonide, administered twice daily, can effectively and safely treat patients with milder forms of asthma. In these patients, triamcinolone acetonide improves asthma symptoms and decreases the need for as-needed beta2-agonists.
国内和国际指南推荐，除最轻微形式的哮喘患者外，其他哮喘患者均应使用吸入性抗炎药物。患者可能也更能接受每日两次给药。
评估400微克 bid的曲安奈德在轻至中度哮喘患者中的疗效和安全性。
一项多中心、随机、双盲、安慰剂对照研究，基线期为7至21天，治疗期为6周。仅使用β2激动剂控制不佳的成年轻至中度哮喘患者被随机分为接受安慰剂（48例）或曲安奈德（53例）治疗。患者在日记卡上记录白天和夜间哮喘症状、沙丁胺醇使用情况以及早晚呼气峰值流速（PEF）。临床肺功能测定指标包括第一秒用力呼气容积（FEV1）、25%至75%用力呼气流量（FEF25 - 75%）、用力肺活量（FVC）、FEV1/FVC以及PEF。
曲安奈德治疗使FEV1较基线改善17%（P <.0001）；沙丁胺醇使用量减少44%（P =.0009）；FVC改善9%（P =.0185）；PEF改善19%（P =.0011）；FEF25 - 75%改善42%（P <.0001）；FEV1/FVC改善8%（P =.0016）；白天哮喘症状改善36%，夜间改善39%，总哮喘症状改善38%（P ≤. =0001）；早晨PEF改善12%，晚上改善10%（P ≤.001）。与安慰剂相比，这些变化具有高度显著性（P ≤.0185）。在积极治疗的1至2周内，所有变量均显示出显著改善，且在6周治疗期内大多数变量保持改善。两种治疗耐受性均良好。安慰剂组呼吸道不良事件发生频率更高；曲安奈德组咽炎报告频率更高。
每日两次给药的曲安奈德可有效且安全地治疗症状较轻的哮喘患者。在这些患者中，曲安奈德可改善哮喘症状并减少按需使用β2激动剂的需求。
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