Efficacy of nasal mometasone for the treatment of chronic sinonasal disease in patients with inadequately controlled asthma.
Efficacy of nasal mometasone for the treatment of chronic sinonasal disease in patients with inadequately controlled asthma.
复制标题
DOI：
10.1016/j.jaci.2014.06.038
复制
发表时间：
2015-03
影响因子：
14.2
通讯作者：
Wise, Robert A.
中科院分区：
文献类型：
--
作者：
Dixon, Anne E.;Dixon, Anne E.;Castro, Mario;Cohen, Rubin I.;Gerald, Lynn B.;Holbrook, Janet T.;Irvin, Charles G.;Mohapatra, Shyam;Peters, Stephen P.;Rayapudi, Sobharani;Sugar, Elizabeth A.;Wise, Robert A.
慢性鼻窦疾病在哮喘中很常见，并且与哮喘控制不良相关;然而，没有长期试验说明慢性鼻窦疾病治疗是否改善哮喘控制。通过儿童哮喘控制试验（cACT）和哮喘控制试验（ACT）分别测定儿童和成人慢性鼻窦疾病鼻用皮质类固醇治疗是否可改善哮喘控制。安慰剂与鼻用莫米松治疗哮喘控制不佳的成人和儿童的24周多中心随机安慰剂对照双盲试验随机分配治疗，并隐藏分配。237名成人和151名儿童被随机分配到鼻用莫米松组和安慰剂组，319名参与者完成了研究。莫米松组与安慰剂组的cACT（莫米松组变化差异-安慰剂组变化[ΔM - ΔP]：-0.38，CI：-2.19至1.44，p = 0.68，6至11岁）或ACT（ΔM - ΔP：0.51，CI：-0.46至1.48，p = 0.30，12岁及以上）无差异。在6 - 17岁的儿童和青少年中，哮喘或鼻窦症状没有差异，但通过峰值流量下降定义的控制不良哮喘发作减少。在成人中，通过哮喘症状效用指数测量的哮喘症状存在微小差异（ΔM - ΔP：0.06，CI：0.01至0.11，p <0.01）和鼻部症状（鼻窦症状评分ΔM - ΔP：-3.82，CI：-7.19至-0.45，p =0.03），但莫米松组与安慰剂组在哮喘生活质量、肺功能或哮喘控制不良发作方面无差异。使用鼻用皮质类固醇治疗慢性鼻窦疾病24周并不能改善哮喘控制。治疗鼻窦疾病的哮喘应根据治疗鼻窦疾病的需要来决定，而不是为了改善哮喘控制。
Chronic sinonasal disease is common in asthma and associated with poor asthma control; however there are no long term trials addressing whether chronic treatment of sinonasal disease improves asthma control. To determine if treatment of chronic sinonasal disease with nasal corticosteroids improves asthma control as measured by the Childhood Asthma Control Test (cACT) and Asthma Control Test (ACT) in children and adults respectively. A 24 week multi-center randomized placebo controlled double-blinded trial of placebo versus nasal mometasone in adults and children with inadequately controlled asthma. Treatments were randomly assigned with concealment of allocation. 237 adults and 151 children were randomized to nasal mometasone versus placebo, 319 participants completed the study. There was no difference in the cACT (difference in change with mometasone – change with placebo [ΔM - ΔP]: -0.38, CI: -2.19 to 1.44, p = 0.68 ages 6 to 11) or the ACT (ΔM - ΔP: 0.51, CI: -0.46 to 1.48, p = 0.30, ages 12 and older) in those assigned to mometasone versus placebo. In children and adolescents, ages 6 to 17, there was no difference in asthma or sinus symptoms, but a decrease in episodes of poorly controlled asthma defined by a drop in peak flow. In adults there was a small difference in asthma symptoms measured by the Asthma Symptom Utility Index (ΔM - ΔP: 0.06, CI: 0.01 to 0.11, p <0.01) and in nasal symptoms (sinus symptom score ΔM - ΔP: -3.82, CI: -7.19 to- 0.45, p =0.03), but no difference in asthma quality of life, lung function or episodes of poorly controlled asthma in adults assigned to mometasone versus placebo. Treatment of chronic sinonasal disease with nasal corticosteroids for 24 weeks does not improve asthma control. Treatment of sinonasal disease in asthma should be determined by the need to treat sinonasal disease rather than to improve asthma control.
登录
查看更多内容
DOI：
10.1164/ajrccm/146.1.122
发表时间：
1992-07-01
期刊：
AMERICAN REVIEW OF RESPIRATORY DISEASE
影响因子：
--
作者：
AUBIER, M;LEVY, J;HERMAN, D
通讯作者：
HERMAN, D
影响因子：
5.1
作者：
Meltzer, Eli O.;Baena-Cagnani, Carlos E.;Teper, Ariel
通讯作者：
Teper, Ariel
DOI：
10.1164/ajrccm.161.6.9906121
发表时间：
2000-06-01
影响因子：
24.7
作者：
Braunstahl, GJ;Kleinjan, A;Fokkens, WJ
通讯作者：
Fokkens, WJ
影响因子：
9.6
作者：
Dixon, Anne E.;Kaminsky, David A.;Irvin, Charles G.
通讯作者：
Irvin, Charles G.
影响因子：
8
作者：
Asmussen, L;Olson, LM;Weiss, KB
通讯作者：
Weiss, KB