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【medical-news】LABAs+ICS治疗改善呼气峰流值
However, Elcio Vianna (University of Sao Paulo Medical School at Ribeirao Preto, Brazil) and colleagues warn that a consequent increase of leukocyte viability in cell culture may be a matter of concern and needs further investigation. The researchers recruited a total of 32 asthma patients with moderate-to-severe disease who were given ICS (400 μg/day) for a 5-week run-in period, and were then randomly assigned to receive either a doubled dose of ICS (800 μg/day: BUD group, n=19) or ICS plus LABA (400 μg and 24 μg/day: FORMO group, n=13) for 9 weeks.
Morning and night PEF values increased in the FORMO group during the treatment period, from 435 to 489 l/min and 428 to 496 l/min, respectively, and the rate of exacerbations in the FORMO group was lower than in the BUD group, at 1 versus 8.
However, neutrophil counts in sputum increased in both groups and leukocyte viability after 48-hour cell culture increased in the FORMO group.
Our findings suggest that adding a LABA to low-dose ICS or doubling the ICS dose does not modify significantly the inflammatory status of asthmatics with moderate-to-severe disease. This may be due to the flat dose−response curve of ICS or to the fact that these patients need even higher doses,the authors note in the journal Respiratory Research.
The sputum cell culture evaluations led to some concern about pro-inflammatory effects of LABAs, but further studies are necessary to assess action of commonly used drugs on inflammatory airway cells,they add.
The team concludes: 揥e also showed that the add-on therapy protects from exacerbations and improves functional parameters.
Respir Res 2008; Advance online publication
Adding LABAs to ICS treatment improves peak expiratory flows
7.21, 2008 – MedWire新闻：吸入类固醇(ICS)联合一种长效β2激剂(LABA)治疗可改善呼气峰流值 (PEF)并预防急性发作，研究者报道.
研究小组选取32个中-重度哮喘病人，洗脱期给予ICS (400 μg/day) 5周，随后随机分配为接受双倍剂量ICS (800 μg/day: BUD group, n=19) 或ICS+LABA (400 μg and 24 μg/day: FORMO group, n=13) 共9周。治疗期FORMO组早晚PEF值均增加, 分别由435至489 l/min、428至496 l/min；急性发作率也低于BUD组。然而，两组患者痰中性粒细胞计数增加且FORMO组粒细胞培养48h后活力增强。因而, 巴西Ribeirao Preto Sao Paulo大学医学院Elcio Vianna教授等警告说伴随的白细胞活力增强可能是个值得担心的问题，需要进一步研究。
作者在呼吸研究杂志分析认为，上述研究提示低剂量ICS联合LABA或倍增ICS剂量对中-重度哮喘的炎症状态无显著修饰效应，此可能系ICS剂量反应曲线平台所致或该部分患者需更高剂量ICS。
虽然痰细胞培养显示LABAs的促炎效应，这点值得忧虑，但进一步分析常规使用药物对气道炎症细胞的效应是必要的，他们补充说.
研究小组推论: 揥e 也显示联合治疗阻止哮喘加重并改善功能指标.
Respir Res 2008; Advance online publication [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-05-25 05:14
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