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【medical-news】COPD：溴化异丙托品-福莫特罗优于沙
NEW YORK (Reuters Health) Aug 25 - Combination therapy with tiotropium and formoterol achieves great improvement in daytime lung function (FEV1) in patients with moderate COPD than does salmeterol and fluticasone, Dutch and German researchers report in the August issue of Chest.
Dr. Klaus F. Rabe of Leiden University Medical Center and colleagues note that inhaled corticosteroids such as fluticasone along with a long-acting bronchodilator is a popular choice for patients with COPD. However, they observe, use of two bronchodilators from different classes might be of greater help.
To investigate, the researchers studied 592 patients with moderate COPD who were randomized to treatment with once daily tiotropium and twice daily formoterol or twice daily salmeterol and twice daily fluticasone.
At 6 weeks, the team found that the 12-hour FEV1 profile in the tiotropium-formoterol combination patients was generally higher than in those given the salmeterol-fluticasone combination. Other measures of lung function also favored the tiotropium group.
Both treatments were well tolerated.
The findings, say the investigators, "support current treatment recommendations in moderate COPD to combine two bronchodilators of different classes rather than to add an inhaled corticosteroid," if a single bronchodilator is not sufficient.
Given these results, the researchers conclude, "Long-term studies in patients with severe COPD are warranted to assess the relative efficacy of different treatment combinations."
Dr. Mario Cazzola of the University of Rome 'Tor Vergata', a co-author of an accompanying editorial, told Reuters Health that COPD is a heterogenous disease that is often approached as a homogeneous disease. So even now, there is disagreement about how best to treat it.
Because of this, there is limited attention "to the degree of severity according to the lung function, whereas we should prefer a symptomatic approach to therapy," he noted.
Chest 2008;134:255-262.
COPD：溴化异丙托品-福莫特罗优于沙美特罗-氟替卡松
纽约(路透健康通讯社) 8.25 -荷兰与德国研究人员在Chest 杂志第8期报道，溴化异丙托品和联合治疗中度COPD较沙美特罗-氟替卡松取得更佳日间肺功能(FEV1)改善。
Leiden大学医疗中心Dr. Klaus F. Rabe及同事指出，吸入皮质激素如氟替卡松联合一种长效支气管扩张剂是COPD病人的普通选择；然而，他们观察发现使用两种不同种类的支气管扩张剂可能效果更好.
研究者调查了592位中度COPD患者，这些患者随机分为每日一次溴化异丙托品和两次福莫特罗或每天两次沙美特罗和氟替卡松.
至第6周,研究组发现使用溴化异丙托品-福莫特罗组病人12-h FEV1总体上普遍高于沙美特罗-氟替卡松组病人；溴化异丙托品组肺功能其他参数受惠也更明显.
两组治疗耐受良好.
研究者宣称，上述发现"支持中度COPD目前的推荐治疗方案即如果单用一种支气管扩张剂效果不佳，联合两种不同种类的支气管扩张剂而不是增加吸入类固醇,".
基于这些结果，研究者推论, "长期研究严重COPD 病人以评定不同治疗复合的相对效力是必要的"
副编辑、合著者--罗马 'Tor Vergata'大学Dr. Mario Cazzola，告诉路透健康社，COPD是一种异源性疾病，但通常显现为同质性疾病；因此，直至目前，如何最优化治疗COPD人们意见仍不一致.
正因如此, 过分注重"肺功能的严重程度有其局限性, 而我们应该首先选择针对症状的治疗"
Chest 2008;134:255-262
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作者:admin@医学,生命科学 2010-11-25 15:14
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