哮喘未控制患者由沙美特罗/氟替卡松向福莫特罗/布地奈德转换后的疗效
2012/05/08
背景：激素吸入（ICS）和长效β2受体激动剂（LABA）同一个吸入器联合治疗是哮喘管理的一个主要治疗方法。目前在日本，可以采用沙美特罗/氟替卡松联合（SFC）和固定剂量的福莫特罗/布地奈德联合（FBC）治疗。然而，有关怎样选择两者了解甚少。本研究旨在SFC治疗后哮喘仍未得到完全控制的哮喘患者中，评价SFC向FBC转换后的疗效。
方法：本试验为一项前瞻性、多中心、开放标记、非对照纵向研究。87名成人患者入选本研究。这些患者采用SFC 50/250μg 每日两次吸入治疗，对其采用5个项目的哮喘控制问卷调查（ACQ5）评价，其评分高于0.75。SFC转换为4.5/160μg每日吸入两次。研究转归包括治疗结束时的ACQ-5评分、呼气峰值流速（PEF）、FEV1和呼出气一氧化氮（FeNO）。
结果：83名患者完成此项研究。ACQ-5评分得到改善。治疗12周后ACQ-5改善具有显著性。37名患者获得哮喘较好控制（ACQ-5评分≤0.75）。在从SFC向FBC转换后，最小和最大PEF和FEV1显著改善，但FeNO未见差异。
结论：哮喘治疗中若哮喘未得到最佳控制，转换ICS/LABA联合治疗方案可以作为一个有效的选择。
方法：本试验为一项前瞻性、多中心、开放标记、非对照纵向研究。87名成人患者入选本研究。这些患者采用SFC 50/250μg 每日两次吸入治疗，对其采用5个项目的哮喘控制问卷调查（ACQ5）评价，其评分高于0.75。SFC转换为4.5/160μg每日吸入两次。研究转归包括治疗结束时的ACQ-5评分、呼气峰值流速（PEF）、FEV1和呼出气一氧化氮（FeNO）。
结果：83名患者完成此项研究。ACQ-5评分得到改善。治疗12周后ACQ-5改善具有显著性。37名患者获得哮喘较好控制（ACQ-5评分≤0.75）。在从SFC向FBC转换后，最小和最大PEF和FEV1显著改善，但FeNO未见差异。
结论：哮喘治疗中若哮喘未得到最佳控制，转换ICS/LABA联合治疗方案可以作为一个有效的选择。
（苏楠 审校）
Allergol Int. 2012 Mar 25;0(0). [Epub ahead of print]
Allergol Int. 2012 Mar 25;0(0). [Epub ahead of print]
Akamatsu T, Shirai T, Kato M, Hashimoto D, Yasui H, Inui N, Suda T, Yokomura K, Hayakawa H, Ide K, Toyoshima M, Kuroishi S, Yasuda K, Suganuma H, Yamada T, Masuda M, Chida K.
Source
Department of Respiratory Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
Abstract
BACKGROUND: Combination therapy with an inhaled corticosteroid (ICS) and a long-acting β(2)-agonist (LABA) in a single inhaler is the mainstay of asthma management and salmeterol/fluticasone combination (SFC) and fixed-dose formoterol/budesonide combination (FBC) are currently available in Japan; however, there is nothing to choose between the two. The purpose of this study was to clarify the effect of switching from SFC to FBC in patients with asthma not adequately controlled under the former treatment regimen.
METHODS: This was a prospective, multicenter, open-label, uncontrolled longitudinal study in 87 adult patients with an Asthma Control Questionnaire, 5-item version (ACQ5) score of greater than 0.75 under treatment with SFC 50/250μg one inhalation twice daily (bid). SFC was switched to FBC 4.5/160μg two inhalations bid. Study outcomes included ACQ5 score, peak expiratory flow (PEF), FEV(1), and fractional exhaled nitric oxide (FeNO) at the end of treatment period.
RESULTS: Eighty-three patients completed the study. ACQ5 scores improved and exceeded the clinically meaningful difference after 12 weeks of treatment and well-controlled asthma (ACQ5 score ≤0.75) was attained in 37 (44.6%) patients. Minimum and maximum PEF and FEV(1) values improved significantly, but not FeNO values, after switching from SFC to FBC.
CONCLUSIONS: Switching ICS/LABA combination therapy is a useful option in the management of asthma that is not optimally controlled.
Allergol Int. 2012 Mar 25;0(0). [Epub ahead of print]
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低剂量和高剂量环索奈德治疗12个月的持续哮喘患者，采用骨代谢相关的新标志物进行前瞻性随访
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