吸入的Ciclesonide用于社区的COVID-19:一个安慰剂控制的随机试验
Peter Wark1,2, Ian C Marschner3, Owen Hutchings4
1School of Translational Medicine, Monash University, Melbourne, Australia.
在接种疫苗的人群中,吸入的循环胺并没有加速从急性COVID-19症状中恢复. 目前的证据不支持在COVID-19治疗中使用吸入式皮质类固醇.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 传染性疾病 传染性疾病
- 临床试验 临床试验
背景情况:
- 吸入性皮质类固醇 (ICS) 已被探索用于治疗社区中的急性COVID-19.
- 西克莱索尼德是一种因其潜在的治疗作用而被研究的ICS.
研究的目的:
- 评估14天每天吸入的 (320毫克) 环胺的有效性和安全性,以加速从急性COVID-19症状中恢复.
- 为了在28天内比较循环索尼德和安慰剂组之间的康复时间和症状持续时间.
- 进行针对急性COVID-19的ICS系统审查.
主要方法:
- 一个双臂,双盲,安慰剂控制,基于社区的随机试验.
- 189名参与者在14天内接受了吸入式环胺或安慰剂.
- 主要结局:从所有症状中恢复的时间;次要结局包括持续的恢复和呼吸道症状.
主要成果:
- 在循环索尼德和安慰剂组之间的第一次恢复时间没有显著差异 (中位数为7天,p=0.84).
- 康复率比率为1.04 (95% CI;0.77,1.40). 在此期间,该病例的确诊率为0.4%.
- 在二次结果中没有观察到任何显著差异;治疗是安全的,并且耐受良好.
结论:
- 在高度接种疫苗的人群中 (Omicron变种),吸入的环胺并没有加速从急性COVID-19症状中恢复.
- 试验结果和综合证据不支持使用吸入性皮质类固醇治疗COVID-19.
- 可能需要进一步的研究来探索不同COVID-19背景或患者群体中的ICS.
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