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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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在接受salmeterol的持久性喘患者中,吸入性皮质类固醇的减少和消除:一项随机对照试验.

R F Lemanske1, C A Sorkness, E A Mauger

  • 1University of Wisconsin Children's Hospital, 600 Highland Ave, K4/916-9988, Madison, WI 53792, USA. rfl@medicine.wisc.edu

JAMA
|May 23, 2001
PubMed
概括

在吸入性皮质类固醇 (ICS) 治疗中添加沙米特醇可以使持续性喘的ICS剂量减少50%. 然而,完全取消ICS治疗会导致严重的喘控制损失,因此不建议.

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科学领域:

  • 肺部病理学 肺部病理学
  • 临床药理学 临床药理学

背景情况:

  • 吸入的长效β2-激动剂 (LABA) 是有效的补充疗法,用于改善喘控制,当与吸入性皮质类固醇 (ICS) 结合使用时.
  • 持久性喘通常需要持续使用ICS进行治疗,但与LABA使用一起减少或消除ICS治疗的潜力仍然是研究领域.

研究的目的:

  • 评估减少或取消吸入性皮质类固醇 (ICS) 治疗的可行性,在持久性喘患者接受长效β2-激动剂 (LABA) 补充治疗.

主要方法:

  • 这是一项为期24周的随机,双模拟,并行组试验,涉及175名患有持续性喘的患者,这些患者在吸入的三氨乙化物上得到了亚最佳控制.
  • 患者接受了额外的salmeterol xinafoate,随后随机选择要么将ICS减少50%,然后消除它,要么继续标准的ICS治疗 (主动控制).
  • 主要结局指标是喘治疗失败的时间.

主要成果:

  • 在接受沙米特醇的患者中,降低了50%的ICS,在8周后,与活跃对照组 (2.8%) 相比,治疗失败的趋势增加了 (8.3%).
  • 在萨尔米特醇组中,完全取消ICS治疗导致治疗失败率 (46.3%) 在8周后明显高于活跃对照组 (13.7%).
  • 在ICS消除后,治疗失败的相对风险在降低剂量组与活性对照组相比是4.3倍高 (P<.001).

结论:

  • 对于持久性喘患者,其症状随着沙米特醇的添加而改善,在不显著失去喘控制的情况下,可以减少50%的吸入性皮质类固醇 (ICS) 剂量.
  • 在这种患者群体中,完全取消ICS治疗会导致喘控制的显著恶化,因此不建议.
  • 这些发现支持在添加LABA用于喘管理时ICS剂量减少而不是消除的策略.