Vanto T, Hämäläinen K M, Vahteristo M, Wille S, Njå F, Hyldebrandt N
Department of Pediatrics, Turku University Hospital, Turku, Finland.
J Aerosol Med. 2004 Spring;17(1):15-24. doi: 10.1089/089426804322994424.
The aim of this study was to compare the clinical efficacy, safety, and acceptability of budesonide inhaled from Easyhaler dry powder inhaler (DPI) (Giona Easyhaler, Orion Pharma, Finland) and from Turbuhaler DPI (Pulmicort Turbuhaler, AstraZeneca, Sweden) in the treatment of asthma in children. The 6-month, randomised, double-blind, double-dummy, parallel-group study was conducted in 229 completed, asthmatic children (5-10 years), who were symptomatic at study entry. For the first 2 months, children inhaled budesonide 2 x 200 microg b.i.d. (high-dose treatment period). Thereafter, the daily dose of inhaled budesonide was 2 x 100 microg for 4 months (low-dose treatment period). The study was carried out at 32 centers in Finland, Sweden, Norway, and Denmark. During the high-dose treatment period, the initially symptomatic patients improved in both treatment groups and the achieved control was maintained during the low-dose treatment period. An improvement was seen in the efficacy outcome parameters in the initially symptomatic patients in both treatment groups. Also, there were no differences in the number of asthma exacerbations between the treatments. The urinary free cortisol/creatinine (UCC) ratios were significantly lower in the Turbuhaler group compared to the Easyhaler group after the high-dose treatment period. In addition, there was a slight but statistically significant slower growth rate in the Turbuhaler group after the 6- month treatment period compared with the Easyhaler group. Pulmicort Turbuhaler and Giona Easyhaler are equally effective in the treatment of asthma in children aged 5-10 years old. Budesonide inhaled from Turbuhaler showed slightly greater systemic effects than budesonide inhaled from Easyhaler. The majority of children and parents preferred Easyhaler to Turbuhaler.
本研究旨在比较从易纳器干粉吸入器(DPI)(芬兰奥立安制药公司的吉纳易纳器)和都保DPI(瑞典阿斯利康公司的普米克都保)吸入布地奈德治疗儿童哮喘的临床疗效、安全性和可接受性。这项为期6个月的随机、双盲、双模拟、平行组研究在229名完成研究的哮喘儿童(5 - 10岁)中进行,这些儿童在研究开始时均有症状。在最初的2个月,儿童每日吸入2次,每次200微克布地奈德(高剂量治疗期)。此后,吸入布地奈德的每日剂量为2次,每次100微克,持续4个月(低剂量治疗期)。该研究在芬兰、瑞典、挪威和丹麦的32个中心开展。在高剂量治疗期,两个治疗组中最初有症状的患者病情均有改善,且在低剂量治疗期维持了所达到的控制效果。两个治疗组中最初有症状的患者在疗效结局参数方面均有改善。此外,两种治疗方法在哮喘加重次数上没有差异。高剂量治疗期后,都保组的尿游离皮质醇/肌酐(UCC)比值显著低于易纳器组。此外,6个月治疗期后,都保组的生长速率与易纳器组相比略有下降,但具有统计学意义。普米克都保和吉纳易纳器在治疗5 - 10岁儿童哮喘方面同样有效。从都保吸入的布地奈德显示出比从易纳器吸入的布地奈德略大的全身效应。大多数儿童和家长更喜欢易纳器而非都保。