Abstract:
:The mandatory requirement to eliminate chlorofluorocarbons (CFCs) as propellants in pharmaceutical aerosols has provided the opportunity to enhance significantly the delivery of aerosol drugs to the respiratory tract. This randomized, parallel-group, double-blind, double-dummy, multicentre study was undertaken to assess whether beclomethasone dipropionate (BDP) in hydrofluoroalkane-134a (HFA) provided equivalent control of moderately severe asthma to BDP in CFC but at approximately half the total daily dose, as might be expected from the improved lung deposition of the HFA-BDP extrafine aerosol. The novel study design included a 10-12 day run-in period to confirm that patients met established criteria of moderately severe asthma and were symptomatic on current therapy (inhaled beta-agonist plus CFC-BDP 400-800 micrograms day-1). This run-in period was followed by a short course of oral steroid therapy (prednisolone 30 mg day-1 for 7-13 days) to demonstrate steroid responsiveness [> or = 15% improvement in morning peak expiratory flow (PEF)] and to provide a within-study baseline of improved asthma control. A total of 233 patients were randomized to treatment for 12 weeks with HFA-BDP 800 micrograms day-1 (116 patients) or CFC-BDP 1500 micrograms day-1 (117 patients). The mean change from oral steroid treatment in morning PEF with HFA-BDP was equivalent to that seen with CFC-BDP at all time intervals. Changes in other measures of pulmonary function, asthma symptom scores and beta-agonist use were equivalent in the two treatment groups throughout the 12 week treatment period. The safety profile of HFA-BDP compared favourably with that of CFC-BDP with no unexpected adverse events reported. Fewer patients on HFA-BDP than on CFC-BDP had plasma cortisol levels below the normal reference range after 12 weeks of therapy (5.1% vs. 17.3%, respectively). In conclusion, HFA-BDP extrafine aerosol was found to provide equivalent control of moderately severe asthma to CFC-BDP at approximately half the daily dose with a favourable safety profile, suggesting an improved therapeutic ratio.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
Davies RJ,Stampone P,O'Connor BJdoi
10.1016/s0954-6111(98)90214-1subject
Has Abstractpub_date
1998-06-01 00:00:00pages
23-31eissn
0954-6111issn
1532-3064pii
S0954-6111(98)90214-1journal_volume
92 Suppl Apub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::Inhaled lignocaine appeared to have considerable steroid sparing properties in an uncontrolled trial in 20 patients with oral-steroid-dependent asthma. Since it can also cause bronchoconstriction, safety needs to be studied under controlled conditions. We have performed a randomized, double-blind, placebo-controlled s...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0954-6111(98)90142-1
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:The prevalence of depression in stable COPD patients varies markedly, possibly because of use of different scales. We aimed to assess depression using 2 different depression scales and to examine the association between depression and poor exercise performance, BODE index and muscle wasting in clinically sta...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2008.11.021
更新日期:2009-10-01 00:00:00
abstract::Capsaicin has long been known to act selectively on a subpopulation of neurons to produce initial excitation, followed by a prolonged neuroinhibitory action commonly referred to as 'capsaicin desensitization'. This property has been exploited extensively as a tool with which to investigate the role of these nerves in ...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/s0954-6111(06)80252-0
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Several animal studies, and one inoculation study in adult asthmatics have shown that interleukin-33 (IL-33) is a major contributor to type-2 inflammation in acute asthma. However, the link between IL-33 and type-2 inflammation has not been shown in naturally occurring asthma exacerbations. OBJECTIVES:To de...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2018.05.016
更新日期:2018-07-01 00:00:00
abstract::RANTES has been implicated in the allergic inflammation of asthma by promoting the migration and activation of the inflammatory cells, including eosinophils. The study was undertaken to evaluate RANTES levels in the exhaled breath condensate (EBC) of asthmatics with different degrees of asthma severity. EBC was collec...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2008.03.010
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Individuals with chronic respiratory conditions are at-risk for depression and anxiety. In the largest mental health screening study of over 6000 people with cystic fibrosis (CF) and 4000 parent caregivers (TIDES, 2014), rates of symptomatology were two to three times higher than in the general population. I...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2020.106147
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) severity is usually graded upon the FEV(1) reduction and FEV(1) has been considered the most important mortality predictor with age in COPD. Recent studies suggest other factors as more powerfully related to mortality than FEV(1) in COPD patients. AIM:To assess t...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2007.11.004
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:We investigated the real-world effectiveness of several drugs (including short- and long-acting beta-agonists [SABAs and LABAs], inhaled corticosteroids [ICS], and antibiotics) in preventing severe asthma exacerbations by carrying-out a large observational study based on the healthcare utilization databases o...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2016.05.004
更新日期:2016-10-01 00:00:00
abstract::Previous studies of acupuncture in asthma have reported conflicting results, some claiming benefit for some patients. We conducted a randomized, double-blind (patient and evaluator) study in 23 non-smoking asthmatics (10 M; 13 F) aged 43 +/- 15 years with forced expiratory volume in 1 s (FEV1) 59 +/- 16% pred. After i...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0954-6111(98)90409-7
更新日期:1998-09-01 00:00:00
abstract::In an attempt to establish the protection afforded by regular salmeterol use against induced bronchoconstriction in asthmatic patients, a meta-analysis was conducted on nine double-blind clinical trials that fulfilled the inclusion criteria. In each trial, subjects were randomly assigned to receive either salmeterol 5...
journal_title:Respiratory medicine
pub_type: 杂志文章,meta分析
doi:10.1016/s0954-6111(98)90012-9
更新日期:1998-05-01 00:00:00
abstract::Although the principles of asthma management are well established in Europe, the available data indicate that asthma in patients is not well controlled. Many patients derive incomplete benefit from their inhaled medication because they do not use inhaler devices correctly and this may compromise asthma control. The Ae...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rmed.2006.01.008
更新日期:2006-09-01 00:00:00
abstract::The Darlington/Northallerton prospective study of asthmatics referred to secondary care started in 1983, with review and new entry at 5-yr intervals. The principal outcome measures are: mortality (presented here), best function and therapeutic step. All adult asthmatics with > or = 15% peak flow (PEF) reversibility to...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(98)90228-1
更新日期:1998-11-01 00:00:00
abstract::This double-blind, placebo-controlled, crossover study was performed to evaluate the effect of terbutaline administered by a turbuhaler on spirometry, walking distance and dyspnoea during exercise in patients with chronic obstructive lung disease (COLD) and to evaluate relationships between changes in spirometry and w...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0954-6111(06)80221-0
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVES:To analyze the conditions of psychological dysfunction and positive mental health in patients with asthma and chronic bronchitis (CB), as compared to healthy individuals, and to identify the factors associated with these mental health indicators. METHODS:Cross-sectional study based on data obtained from the...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2012.03.021
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:The inhaled corticosteroid fluticasone furoate (FF) is efficacious as a once-daily treatment for the management of asthma. Asthma is associated with circadian changes, with worsening lung function at night. We compared the efficacy of once-daily FF in the morning or evening for the treatment of asthma. METH...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2015.12.011
更新日期:2016-03-01 00:00:00
abstract::Rounded atelectasis of the lung (RA) is a lesion well described in the medical literature, yet often very difficult to diagnose. In recent years, the widespread use of high-resolution imaging modalities employed in the struggle against cancer, coinciding with the peak of the asbestos epidemic, have boosted the detecti...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2004.10.003
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVES:This randomized, double-blind, placebo-controlled, cross-over, Phase II dose-ranging study investigated the efficacy and safety of GP MDI (glycopyrronium administered by metered dose inhaler formulated using co-suspension delivery technology) compared with an open-label active comparator, salmeterol dry powd...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2018.04.013
更新日期:2018-06-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) is now the most common indication for single lung transplantation. In long-term follow-up, obliterative bronchiolitis is a major problem. The aim of the present study was to perform a long-term follow-up of the pulmonary function and to examine the effect of development of ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(96)90148-1
更新日期:1996-10-01 00:00:00
abstract::Metered dose inhalers (MDIs) are the mainstay of inhaled steroid therapy for asthma. With the phasing out of traditional chlorofluorocarbon (CFC) propellants and their replacement with a new generation of CFC-free products, it is becoming clear that formulation and inhaler characteristics can markedly affect the drug ...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/s0954-6111(99)90000-8
更新日期:1999-03-01 00:00:00
abstract::Gastroesophageal reflux disease (GERD) is commonly associated with asthma; however, frequency in nonatopic children with asthmatic symptoms is unknown. The aim of this study was to determine the frequency of gastroesophageal reflux (GER) in nonatopic children with asthma-like airway disease that recur despite conventi...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2005.07.006
更新日期:2006-03-01 00:00:00
abstract::The purpose was to compare the short-term cost-effectiveness of intensive vs conventional education and supervision for the self-management of mild asthmatic patients. Consecutive newly diagnosed asthmatic patients (n = 162) were randomized into an intervention group (IG) and a control group (CG) with 1 yr of treatmen...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0954-6111(98)90113-5
更新日期:1998-02-01 00:00:00
abstract::We have proposed a clinical treatment guideline for the management of acute, severe asthma and chronic obstructive pulmonarydisease (COPD) using the principles of evidence-based medicine. The content is based upon practical clinical issues in need of consensus. A previous study has shown that this particular area is i...
journal_title:Respiratory medicine
pub_type: 指南,杂志文章,实务指引
doi:10.1053/rmed.2002.1332
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Although respiratory muscle weakness (RMW) is known to predict prognosis in patients with heart failure with reduced ejection fraction (HFrEF), RMW prevalence and its prognosis in those with preserved ejection fraction (HFpEF) remain unknown. We aimed to investigate whether the RMW predicted mortality in HFp...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2019.105834
更新日期:2020-01-01 00:00:00
abstract::This manuscript offers an approach to the treatment of pulmonary sarcoidosis based on current available information. The treatment of pulmonary sarcoidosis is not mandatory as the disease may be self-limiting and therapy is often associated with significant drug side effects. The decision to treat rests predominantly ...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rmed.2012.01.013
更新日期:2012-10-01 00:00:00
abstract::This retrospective study reviews the patterns of P. cepacia pulmonary infection in 75 of a total of 872 mainly adults with cystic fibrosis, registered here during the 4 years 1987-1990; 35 (47%) were female. During this period, 55 patients acquired P. cepacia and the annual incidence and prevalence rates have remained...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/0954-6111(93)90090-m
更新日期:1993-04-01 00:00:00
abstract::Intrapulmonary percussive ventilation (IPV) is a ventilatory technique that delivers bursts of high-flow respiratory gas into the lung at high rates, intended for treating acute respiratory failure and for mobilization of secretions. We performed a study, aimed at assessing the physiological response to IPV, on patien...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2006.01.010
更新日期:2006-09-01 00:00:00
abstract:INTRODUCTION:Children with asthma often have normal spirometry despite significant disease. The pathology of the small airways in asthma may be assessed using Multiple Breath Washout (MBW) and calculating the Lung Clearance Index (LCI). There are only few studies using MBW in children with asthma and existing data rega...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2014.07.003
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:It has been shown that interleukin (IL)-18 levels in induced sputum are reduced in asthmatic and healthy smokers. However, in chronic obstructive pulmonary disease (COPD) patients, recent data show an overproduction in the lungs and increased serum levels of IL-18, suggesting that IL-18 may be involved in th...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2009.01.011
更新日期:2009-07-01 00:00:00
abstract::Smoking and body mass index (BMI) are well-documented risk factors that contribute substantially to chronic obstructive pulmonary disease (COPD) and asthma. However, the relations among smoking, obesity, and COPD or asthma remain to be clarified. We conducted a population-based cross-sectional epidemiologic study to e...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2013.04.021
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Fluticasone furoate/vilanterol (FF/VI) is an inhaled corticosteroid/long-acting beta2-agonist (ICS/LABA), recently approved as once-daily maintenance therapy for COPD. We compared the lung function effects of FF/VI with those of twice-daily fluticasone propionate/salmeterol (FP/SAL). METHODS:Three 12 week s...
journal_title:Respiratory medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.rmed.2014.05.008
更新日期:2014-08-01 00:00:00