A Comparative Study of Fluticasone Propionate, Mometasone Furoate, and Saline Nasal Spray in the Treatment of Children with Adenoid Hypertrophy

Introduction:Adenoidectomy is currently considered the treatment of choice for relief of the nasal airway obstruction due to adenoid hypertrophy. Evidence suggests that topical nasal steroid sprays can cause a reduction in adenoid size. We aim to compare the effectiveness of fluticasone propionate, mometasone furoate (MF) and saline nasal sprays in relieving the signs and symptoms of adenoid hypertrophy and in reducing the size of the adenoids. MaterialsandMethods: We conducted a randomized comparative study on 60 patients divided into three groups A, B, C (20 each). Group A patients treated with fluticasone propionate nasal spray (400 μg/day), Group B patients treated with MF nasal spray (100 μg/day), and Group C patients treated with saline spray (0.65% w/v in purified water which is made isotonic and buffered). Treatment was given up to 12 weeks with follow‑up at 4, 8, and 12 weeks and at each follow‑up visit assessment was done. Final data were analyzed using SPSS software version 21 and numerical variables associated with different groups were analyzed and analysis of variance test was used. Results: Diagnostic nasal endoscopy and X‑ray grades at day 1 among the study groups were not statistically significant, whereas, at 12 weeks results among fluticasone and mometasone groups were significantly better (P < 0.001) as compared to the saline group. There was a significant improvement in the symptoms under all the categories with the use of fluticasone and mometasone. Conclusion: In our study, both fluticasone propionate and MF were able to effectively reduce symptoms and signs of adenoid hypertrophy as well as help in reducing the size of the enlarged adenoid. Both these drugs were well tolerated by the patients

Efficacy of fluticasone propionate cream alone or in combination with calcipotriol ointment in the treatment of mild to moderate plaque psoriasis: a randomized self-controlled study / 中华皮肤科杂志

Objective:To evaluate short-term efficacy and safety of fluticasone propionate 0.05% cream alone or in combination with calcipotriol 0.005% ointment in the treatment of mild to moderate plaque psoriasis.Methods:From October 2020 to January 2021, a randomized, open-labeled, self-controlled clinical trial was conducted among 30 patients with mild to moderate plaque psoriasis in Beijing Friendship Hospital. Skin lesions on the extremity of one side were topically treated with calcipotriol 0.005% ointment in the morning and fluticasone propionate 0.05% cream in the evening (combination group) , and lesions on the contralateral extremity were topically treated with fluticasone propionate 0.05% cream twice a day (fluticasone propionate group) . The treatment lasted 4 weeks. Before and 1, 2, 4 weeks after the start of treatment, the patients were followed up, clinical indices including static physician′s global assessment (sPGA) and psoriasis area and severity index (PASI) were evaluated, and adverse events were recorded. Efficacy and safety were evaluated by using repeated measures analysis of variance, multivariate analysis of variance, Mann-Whitney rank sum test and two-independent-sample t test. Results:Before the treatment, there was no significant difference in sPGA or PASI score between the combination group and fluticasone propionate group (both P > 0.05) . After 1-week treatment, the fluticasone propionate group showed significantly decreased sPGA (1.10 ± 0.31 points) and PASI scores (1.05 ± 0.51 points) compared with the combination group (1.73 ± 0.45 points, 1.38 ± 0.69 points, F= 40.74, 4.38, respectively, both P < 0.05) ; after 2- and 4-week treatment, the combination group showed significantly decreased sPGA (0.83 ± 0.46 points, 0.23 ± 0.43 points, respectively) and PASI scores (0.53 ± 0.47 points, 0.23 ± 0.50 points, respectively) compared with the fluticasone propionate group (sPGA: 1.03 ± 0.18 points, 0.97 ± 0.32 points, F= 4.88, 56.14, respectively, both P < 0.05; PASI: 1.03 ± 0.51 points, 0.92 ± 0.54 points, F= 15.20, 26.36, respectively, both P < 0.05) . After 1-week treatment, the infiltration/hypertrophy severity score was significantly lower in the fluticasone propionate group than in the combination group ( U= 165.00, P < 0.05) ; after 2- and 4-week treatment, the erythema and scaling severity scores were significantly lower in the combination group than in the fluticasone propionate group (erythema: U= 540.00, 765.00, respectively, both P < 0.05; scaling: U= 825.00, 795.00, respectively, both P < 0.05) . Conclusion:Fluticasone propionate 0.05% cream alone exhibited a rapid onset of efficacy in the treatment of psoriasis, while fluticasone propionate 0.05% cream combined with calcipotriol 0.005% ointment was more effective after 2- and 4-week treatment, and both regimens showed a favorable safety profile.

Efficacy and safety of fluticasone propionate nasal spray in treatment ofadenoidal hypertrophic snoring in children

Abstract This study investigatedthe efficacy and safety offluticasone propionate nasal spray in treatment of adenoidal hypertrophic snoring in children.Fifty-six children with adenoidal hypertrophic snoring were enrolled. According to adenoidal-nasopharyngeal ratio (ANR) in lateral nasal X-ray examination,the children were assigned in moderategroup (23 cases) and severegroup (33 cases).The fluticasone propionate nasal spray was used for all patientsfor 4 weeks.In 56 patients, after treatment, compared with before treatment, the snoring, sleep apneaand nasal obstruction scores in moderategroupand the nasal obstruction score in severegroupwere significantly decreased,respectively (P < 0.05).The decreases of snoring, sleep apnea, mouth breathing and nasal obstruction scores after treatment in moderate group were significantly higher than those in severe group, respectively (P <0.001).After treatment, in 18 patients with ateral nasal X-ray examination,the adenoid size was obviously reduced, and the nasopharynx airway was obviously enlarged. The meanANRdropped from 0.76±0.10 to 0.72±0.09(P <0.001).Duringtreatment, only 2 of 56 patients were reported with intranasal dryness and occasional epistaxis, which were self-healed without treatment.Fluticasone propionate nasal spray is effective and safe for treatment of children's snoring caused by adenoidal hypertrophy.

Síndrome de Cushing exógeno por interacción medicamentosa de ritonavir y fluticasona inhalada. Reporte de tres casos pediátricos / Exogenous Cushing syndrome due to drug interaction of ritonavir and inhaled fluticasone. Report of three pediatric cases

El incremento de la expectativa de vida con el advenimiento de la terapia antirretroviral de alta eficacia plantea desafíos en cuanto a la toxicidad e interacciones medicamentosas. El síndrome de Cushing exógeno por interacción entre ritonavir y fluticasona inhalada en niños con diagnóstico de infección por virus de la inmunodeficiencia humana y patología pulmonar crónica es infrecuente. Hasta el momento, hay 20 casos reportados. Se describen 3 casos pediátricos con diagnóstico de infección por virus de la inmunodeficiencia humana y patología pulmonar crónica que presentaron síndrome de Cushing exógeno con fluticasona inhalada en dosis habituales por la interacción medicamentosa entre esta y ritonavir. Los pacientes resolvieron el cuadro clínico luego de 2-4 meses de suspensión de la fluticasona y permanecieron asintomáticos en el seguimiento

The increase in life expectancy with the advent of highly effective antiretroviral therapy poses challenges in terms of toxicity and drug interactions. Exogenous Cushing syndrome by interaction between ritonavir and inhaled fluticasone in children diagnosed with human immunodeficiency virus infection and chronic pulmonary pathology is rare. So far, there are 20 cases reported. Three pediatric cases are reported, with a diagnosis of human immunodeficiency virus infection and chronic pulmonary pathology who presented exogenous Cushing syndrome with inhaled fluticasone at usual doses due to drug interaction between it and ritonavir. The patients resolved the clinical Síndrome de Cushing exógeno por interacción medicamentosa de ritonavir y fluticasona inhalada. Reporte de tres casos pediátricos Exogenous Cushing syndrome due to drug interaction of ritonavir and inhaled fluticasone. Report of three pediatric cases picture after 2-4 months of fluticasone suspension and remain asymptomatic in the follow-up.

Comparative Study of Topical Treatment in Allergic Rhinitis Using Azelastine and Fluticasone in a Combination Verses Fluticasone Propionate Alone.

Background: Amongst the common problems facedglobally, Allergic Rhinitis (AR) is very distressing attimes. This is an inflammatory response to either knownor unknown allergen. The symptomatic relief in ARusing topical steroid Fluticasone propionate andantihistaminic Azelastine Hydrochloride in acombination has been studied. Very few studies showingcomparison between these two drugs in a combinationand steroid alone are available in the literature. Aim andObjectives: To study the effectiveness of topicaltreatment using corticosteroid Fluticasone propionateand antihistaminic in a combination versus Fluticasonepropionate alone in patients of AR. Material andMethods: The cases presented with symptoms ofallergic rhinitis were randomized in two groups at startof treatment. All cases of Group I were treated withFluticasone propionate whereas of Group II withFluticasone propionate and Azelastine hydrochloridecombination. In each group, the individual symptomscores were recorded pre-treatment and post-treatmentat the end of four weeks with the help of symptomevaluation scale. Based on these individual symptomscores, the Total Symptom Score (TSS) was calculated.The effectiveness of group specific drugs was evaluatedby comparing individual and TSS. Results: After fourweeks, both TSS and individual symptom score werereduced in either group (p<0.05). Further, Group IIspecific drug was found more effective than Group-I inrelieving symptoms of AR. Conclusion: TSS decreasedby an average of 84.14% in Group-I (i.e. treated withFluticasone propionate) and by 91.16% in Group–II (i.e.treated with Fluticasone propionate and Azelastinehydrochloride I in a combination).

A comparative study on efficacy and safety of glycopyrronium bromide + salmeterol/fluticasone and tiotropium bromide + salmeterol/fluticasone in hronic obstructive pulmonary disease

Objective: To compare the effect of tiotropium bromide and glycopyrronium bromide in the treatment of chronic obstructive pulmonary disease. Methods: This was an open labeled Randomized controlled trial study. Patients diagnosed with COPD according to the Global Initiative for chronic Obstructive Lung Disease (GOLD) strategy were included in the study. The patients were divided in two groups and each group had 100 patients. Group A- COPD patients on Tiotropium bromide + Salmeterol/Fluticasone; Group B – COPD patient on Glycopyrronium bromide + Salmeterol/Fluticasone. Tiotropium bromide: 18 mcg OD, Glycopyrronium bromide: 50 mcg OD along with Salmeterol 50 mcg/Fluticasone 100mcg was given. Results: The mean age of patients of Group A and Group B was 56.28±7.78 and 57.64±8.06 years respectively. Baseline variables were comparable between the groups. There was significant (p<0.05) difference in PFT parameters between the groups at 12 and 24 weeks except for FEV1/FVC. The mean change was higher in Group B compared to Group A from 0 week to 24 weeks. There was clinical improvement among all the patients in both the groups. Conclusion: Once-daily GLY demonstrated similar effects to TIO when combined with SAL/FP in patients with moderate and severe COPD.

Treatment adherence and level of control in moderate persistent asthma in children and adolescents treated with fluticasone and salmeterol / Adesão ao tratamento e nível de controle da asma persistente moderada em crianças e adolescentes tratados com fluticasona e salmeterol

Abstract Objective: There is a scarcity of studies that assessed the association between adherence to combination therapy and asthma control in pediatric patients. The authors investigated the association between adherence to fluticasone propionate/salmeterol xinafoate combination-metered aerosol and the level of asthma control in children. Methods: This was a prospective observational study of 84 patients aged 5-16 years with moderate persistent asthma, who remained uncontrolled despite the use of 1000 µg/day of inhaled nonextrafine-hydrofluoric alkane-beclomethasone dipropionate in the three months prior to study enrollment. Participants were prescribed two daily doses of FP (125 µg)/salmeterol xinafoate (25 µg) combination by metered aerosol/spacer for six months. Adherence rates were assessed using the device's dose counter after the 2nd, 4th, and 6th months of follow up. Asthma control was assessed using a simplified Global Initiative for Asthma 2014 Report classification. Results: Mean adherence rates after the second, fourth, and sixth months were 87.8%, 74.9%, and 62.1% respectively, for controlled asthma, and 71.7%, 56.0%, and 47.6% respectively, for uncontrolled asthma (all p-values ≤ 0.03). The proportion of children achieving asthma control increased to 42.9%, 67.9% and 89.3% after the 2nd, 4th and 6th months of follow-up, respectively (p ≤ 0.001). Conclusion: Adherence rates between 87.8% in the 2nd month and 62.1% in the 6th month were strong determinants of asthma control.

Resumo Objetivo: São escassos os estudos que avaliaram a relação entre a taxa de adesão à combinação de proprionato de fluticasona/xinafoato de salmeterol e o nível de controle da asma na infância. O presente estudo teve como objetivo avaliar essa relação. Métodos: Estudo prospectivo observacional com 84 participantes, de 5 a 16 anos, todos eles com asma persistente moderada que permaneceram não controlados apesar do uso de 1.000 µg/dia de dipropionato de beclometasona em partículas não extrafinas nos três meses que antecederam a admissão no estudo. Os participantes receberam prescrição de 125 µg de propionato de fluticasona e 25 µg xinafoato de salmeterol através de inalador pressurizado, duas vezes ao dia, e foram avaliados após o 2°, 4° e 6° meses de tratamento. A taxa de adesão foi obtida por meio do contador analógico de doses incorporado ao inalador. A classificação do nível de controle da asma foi baseada numa simplificação das recomendações da Global Initiative for Asthma. Resultados: As taxas de adesão aos 2, 4 e 6 meses para a asma controlada foram 87,8%, 74,9% e 62,1% e para a asma não controlada de 71,7%, 56,0% e 47,6% (p ≤ 0,03), respectivamente. A proporção de pacientes com asma controlada elevou- se para 42,9%, 67,9% e 89,3% nas três avaliações subsequentes (p ≤ 0,001). Conclusões: Taxas de adesão entre 87,8% no 2° mês e de 62,1% no 6° mês foram determinantes para o nível de controle da asma.

Therapeutic effect of salmeterol-fluticasone aerosol on mild to moderate chronic obstructive pulmonary disease / 中国基层医药

Objective@#To analyze the clinical efficacy of salmeterol-fluticasone aerosol in the treatment of mild to moderate chronic obstructive pulmonary disease (COPD).@*Methods@#From February 2017 to February 2018, 68 patients with mild to moderate COPD treated in the General Hospital of Shanxi Tongmei Group were selected in the study.The patients were divided into control group (34 cases) and observation group (34 cases) by random number table method.The control group was treated with salbutamol aerosol inhalation, while the observation group was treated with salmeterol and fluticasone aerosol inhalation.Both two groups were treated for 12 weeks.The clinical efficacy, improvement of pulmonary function, 6-minute walking distance, oxygen saturation and heart rate were compared between the two groups.@*Results@#The total effective rate of the observation group was 97.06% (33/34), which was significantly higher than that of the control group [73.53%(25/34)] (χ2=7.503, P<0.05). Before treatment, FEV1%, FEV1/FVC (percentage of forced expiratory volume in 1 second forced vital capacity), FEV1 (1 second hard breathing volume), blood oxygen saturation, heart rate and 6 min walking distance had no statistically significant differences between the two groups (all P>0.05). After treatment, the FEV1, FEV1/FVC, FEV1% in the observation group were (65.48±4.06)%, (74.66±8.12)%, (1.99±0.55) L, respectively, which were significantly higher than those in the control group [(63.55±6.14)%, (70.85±7.56)%, (1.71±0.52)L] (t=2.321, 2.002, 2.157, all P<0.05). The oxygen saturation, heart rate and 6-minute walking distance in the observation group were (92.27±1.83)%, (80.55±4.08)times/min and (263.35±28.73)m, respectively, which in the control group were (88.52±2.06)%, (91.43±5.16)times/min and (231.95±22.69)m, respectively, and there were statistically significant differences between the two groups (t=7.936, 9.644, 5.001, all P<0.05).@*Conclusion@#Salmeterol and fluticasone aerosol inhalation has good clinical efficacy in the treatment of mild to moderate COPD, and can significantly improve the lung function of patients.

Effect of acupuncture plus medication on the pulmonary ventilation, IFN-γ level and sleep quality in allergic rhinitis patients / 针灸推拿医学（英文版）

Objective:To observe the effect of warm-unblocking acupuncture plus fluticasone propionate nasal spray on the pulmonary ventilation, level of interferon-γ (IFN-γ) and sleep quality in patients with allergic rhinitis (AR). Methods: A total of 112 AR patients were enrolled between January 2013 and August 2018 and were divided into an observation group and a control group by the random number table method, with 56 cases in each group. Patients in the observation group received warm-unblocking acupuncture plus fluticasone propionate nasal spray, and patients in the control group only received fluticasone propionate nasal spray. The nasal symptom score, pulmonary function indexes, the levels of IFN-γ and interleukin (IL)-4 in serum, and sleep quality in the two groups were compared. Results: After treatment, the total effective rate in the observation group was higher than that in the control group (P＜0.05). The nasal symptom score dropped in both groups after treatment (both P＜0.05), and the score in the observation group was lower than that in the control group (P＜0.05). The pulmonary ventilation indexes all increased significantly after treatment in the observation group (all P＜0.05); the forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio (FEV1/FVC) and the forced expiratory flow at 50%, 75% and 25%-75% of the vital capacity (FEF50%, FEF75%, FEF25%-75%) increased after treatment in the control group (all P＜0.05); the pulmonary ventilation indexes were higher in the observation group than those in the control group (all P＜0.05). The level of IFN-γ increased significantly after treatment in the two groups (both P＜0.05) and the level of IL-4 dropped significantly (both P＜0.05); the observation group had a higher IFN-γ level (P＜0.05) and a lower IL-4 level (P＜0.05) compared with the control group. Regarding the Pittsburgh sleep quality index (PSQI), the scores of subjective sleep quality, habitual sleep efficiency and sleep disturbances and the general PSQI score decreased significantly after treatment in both groups (all P＜0.05), and the scores in the observation group were significantly lower than those in the control group (all P＜0.05). Conclusion: Warm-unblocking acupuncture plus fluticasone propionate nasal spray can effectively control the clinical symptoms and improve pulmonary function in the treatment of AR; this approach can regulate the levels of IFN-γ and IL-4 towards the normal range in AR patients; it can also improve patient’s sleep quality. This method can produce more significant efficacy than fluticasone propionate nasal spray used alone.

Investigation on Drugs for Asthma Control Administered by Pediatric Clinicians-Selection of Inhaled Corticosteroids and Compliance Evaluation of Patients / 中国药房

OBJECTIVE： To provide reference for the selection of inhaled corticosteroids （ICS） in clinic. METHODS： A questionnaire survey was conducted among pediatricians from medical institutions of 11 provinces （districts， cities） to analyze the drug selection and reasons， dosage form selection [by comprehensive score （CS）] of 3 kinds of ICS as budesonide （BUD）， beclomethasone （BDP） and fluticasone （FP）， medication compliance and influential factors （by CS）. RESULTS： A total of 200 questionnaires were sent out， and 196 valid questionnaires were collected with effective rate of 98.00％. Pediatric clinicians preferred BUD as a control drug for asthma in children （158 cases， 80.61％）， followed by FP （22 cases， 11.22％） and BDP （2 cases， 1.02％） and the rest had no tendency （14 cases， 7.14％）. Clinicians who chose BUD mainly believed that the drug had better clinical efficacy， and was more recommended by guidelines and experts， more recognized by patients and so on. In addition， of all inhalation equipment for children asthma， pediatric clinicians believed that parents or children were more easier to master atomizer （CS： 4.04）， followed by pressurized metered dose inhalers （pMDI） （with spacer） （CS： 2.75）， pMDI （without spacer） （CS： 1.71）， dry powder inhalers （DPI） （turbuhaler） （CS： 1.46） and DPI （accuhaler） （CS： 1.08）. For the evaluation of patients’ medication compliance， 48 （24.49％）， 88 （44.90％）， 58 （29.59％） pediatricians thought that the actual administration accounted for ＜50％， 50％-74％， 75％-99％ of the medical order dosages， respectively. Only 2 （1.02％） subjects thought that the patients would fully obey. The main factors affecting children’s medication compliance were worrying about side effects of long-term medication （CS： 9.19）， drug withdrawal after improvement （CS： 8.16）， and children’s treatment incompatibility （CS： 7.82）. CONCLUSIONS： Pediatricians tend to choose BUD as drug for asthma control， and atomizer is treated as the easiest inhalation equipment for children. At the same time， pediatricians have low evaluation on the medication compliance of parents and children.

Eficacia de la budesonida/formoterol comparado con la fluticasona/salmeterol en la mejoría de la capacidad pulmonar de personas mayores con Enfermedad Pulmonar Obstructiva Crónica: revisión sistemática de literatura / Effectiveness of budesonide/formoterol compared to fluticasone / salmeterol in improving the lung capacity of older people with Chronic Obstructive Pulmonary Disease: systematic literature review / Eficiência da budesonida/formoterol comparado com fluticasona/salmeterol na melhora da capacidade pulmonar de idosos com Doença Pulmonar Obstrutiva Crônica: revisão sistemática da literatura

Introducción. La Enfermedad Pulmonar Obstructiva Crónica (EPOC) es una patología no transmisible, caracterizada por una limitación de flujo de aire en las vías respiratorias debido a una respuesta inmunológica anormal frente a partículas. Objetivo. Conocer la eficacia que tiene la budesonida/formoterol comparado con la fluticasona/salmeterol en la mejoría de la capacidad pulmonar en personas mayores de 40 años con Enfermedad Pulmonar Obstructiva Crónica. Materiales y métodos. Se realizó una revisión sistemática de documentos producidos entre el año 2000 y 2018 en distintas bases de datos, donde se incluyeron ensayos clínicos. Se identificaron cuatro artículos para el análisis final. Resultados. Durante la evaluación comparativa de budesonida con formoterol, los artículos muestran un total de 709 personas evaluadas, con un promedio de edad de 53,5 años. El 65,4 % eran varones, el 21 % manifestaba no haber consumido tabaco, todos con diagnóstico de Enfermedad Pulmonar Obstructiva Crónica moderada-severa, según la escala GOLD (Global Initiative For Chronic Obstrutive Lung Disease). Los estudios determinaron que al administrar budesonida/formoterol de 400/12 mcg y 320/9 mcg, los pacientes tuvieron una leve mejoría en el Volumen Espiratorio Forzado del primer segundo (VEF1). Solo dos pacientes presentaron efectos adversos. No obstante, para los resultados mencionados anteriormente no se encontró diferencias significativas. Conclusiones. El uso de budesonida/formoterol es eficaz al mejorar la capacidad ventilatoria pulmonar, disminuye el número de exacerbaciones anuales y genera un adecuado control de los síntomas, sin embargo, es igual de efectivo a la fluticasona/salmeterol.

Introduction. Chronic Obstructive Pulmonary Disease (COPD) is a not transmissible disease, characterized by a limitation of airflow in the respiratory tract, due to an abnormal immune response to particles. Objective. This article aims to show that the application of budesonide / formoterol improves lung capacity in people over 40 years with Chronic Obstructive Pulmonary Disease. Materials and methods. A systematic review was conducted in the period between 2000 and 2018 in different databases where clinical trials were included. Four articles were identified for the final analysis. Results. During the comparative evaluation of budesonide with formoterol, a total of 709 people were evaluated, with an average age of 53.5 years, 65.4% were male, 21% reported not having used tobacco, all with a diagnosis of moderate-severe Chronic Obstructive Pulmonary Disease according to the GOLD scale (Global Initiative For Chronic Obstrutive Lung Disease). The studies determined that when budesonide / formoterol of 400/12 mcg and 320/9 mcg was administered, the patients had a slight improvement in the Forced Expiratory Volume of the first second (FEV1). Only two patients presented adverse effects. However, for the results mentioned above no significant differences were found. Conclusions. The use of budesonide / formoterol is effective in improving pulmonary ventilatory capacity, decreases the number of annual exacerbations and generates adequate control of symptoms, however, it is equally effective in fluticasone / salmeterol.

Introdução. A Doença Pulmonar Obstrutiva Crônica (DPOC) é uma patologia não transmissível, caraterizada por uma limitação do fluxo de ar nas vias aéreas devido a uma resposta imune anormal contra partículas. Objetivo. Conhecer a eficiência que apresenta a budesonida/formoterol comparado com fluticasona/salmeterol na melhora da capacidade pulmonar em pessoas com mais de 40 anos com Doença Pulmonar Obstrutiva Crônica. Materiais e métodos. Foi realizada uma revisão sistemática dos documentos produzidos entre 2000 e 2018 em diferentes bancos de dados, onde foram incluídos ensaios clínicos. Quatro artigos foram identificados para a análise final. Resultados. Durante a avaliação comparativa de budesonida com formoterol, os artículos mostram um total de 709 pessoas avaliadas, com uma idade média de 53,5 anos. O 65,4 % eram do sexo masculino, o 21 % disseram que não usavam tabaco, todos diagnosticados com Doença Pulmonar Obstrutiva Crônica moderada a grave, de acordo com a escala GOLD (Global Initiative For Chronic Obstrutive Lung Disease). Os estudos determinaram que administrar budesonida/formoterol de 400/12 mcg e 320/9 mcg, os pacientes apresentaram uma leve melhora no Volume Expiratório Forçado no primeiro segundo (VEF1). Apenas dois pacientes tiveram efeitos adversos. No entanto, não foram encontradas diferenças significativas para os resultados mencionados acima. Conclusões. O uso de budesonida/formoterol é eficaz na melhora da capacidade ventilatória pulmonar, diminui o numero de exacerbações anuais e gera controle adequado dos sintomas, no entanto, é igualmente eficaz para a fluticasona/salmeterol.

Cost-effectiveness of indacaterol/glycopyrronium in comparison with salmeterol/fluticasone combination for patients with moderate-to-severe chronic obstructive pulmonary disease: a LANTERN population analysis from Singapore

<p><b>INTRODUCTION</b>In light of the growing evidence base for better clinical results with the use of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) over inhaled corticosteroid-containing salmeterol/fluticasone combination (SFC), this study aimed to evaluate the cost-effectiveness of IND/GLY over SFC in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are at low risk of exacerbations, in the Singapore healthcare setting.</p><p><b>METHODS</b>A previously published patient-level simulation model was adapted for use in Singapore by applying local unit costs. The model was populated with clinical data from the LANTERN and ECLIPSE studies. Both costs and health outcomes were predicted for the lifetime horizon from a payer's perspective and were discounted at 3% per annum. Costs were expressed in 2015 USD exchange rates. Uncertainty was assessed through probabilistic sensitivity analysis.</p><p><b>RESULTS</b>Compared to SFC, use of IND/GLY increased mean life expectancy by 0.316 years and mean quality-adjusted life years (QALYs) by 0.246 years, and decreased mean total treatment costs (drug costs and management of associated events) by USD 1,474 over the entire lifetime horizon. IND/GLY was considered to be 100% cost-effective at a threshold of 1 × gross domestic product per capita. The cost-effectiveness acceptability curve showed that IND/GLY was 100% cost-effective at a willingness-to-pay threshold of USD 0 (additional cost) when compared to SFC.</p><p><b>CONCLUSION</b>IND/GLY was estimated to be highly cost-effective compared to SFC in patients with moderate-to-severe COPD who are not at high risk of exacerbations in the Singapore healthcare setting.</p>

Efficacy and Safety of Salmeterol/fluticasone Combined with Montelukast versus Salmeterol/fluticasone in the Treatment of Cough Variant Asthma: A Meta-analysis / 中国药房

OBJECTIVE: To evaluate the efficacy and safety of salmeterol/fluticasone combined with montelukast versus salmeterol/fluticasone in the treatment of cough variant asthma, and to provide reference for evidence-based reference in clinic.METHODS: Retrieved from Cochrane library, PubMed, Chinese Journal Full-text Database, VIP and Wanfang database, randomized controlled trials (RCTs) about therapeutic efficacy (total response rate, marked improvement rate, cough disappearance time, 6-12 months recurrence rate) and safety (the incidence of ADR) of salmeterol/fluticasone combined with montelukast (trial group) vs. salmeterol/fluticasone (control group) in the treatment of cough variant asthma were included. Meta-analysis was performed by using Rev Man 5. 3 software after data extraction and quality evaluation with Cochrane system evaluation manual 5. 1. 0. RESULTS: Totally 10 RCTs were included, involving 976 patients. Results of Meta-analysis showed the total response rate [RR=1. 22, 95％CI(1. 16, 1. 29), P<0. 001] and marked improvement rate [RR= 1. 38,95％CI(1. 22,1. 56),P<0. 001] of trial group were significantly higher than those of control group; the cough disappearance time was significantly shorter than control group [MD= - 3. 07, 95％ CI (- 3. 54, -2. 59),P<0. 001],and 6-12 months recurrence rate was significantly lower than control group [RR=0. 24, 95％CI(0. 11, 0. 54), P<0. 001], with statistical significance. There was no statistical significance in the incidence of ADR between 2 groups [RR=1. 58, 95％ CI (0. 99, 2. 51), P=0. 05]. CONCLUSIONS: The salmeterol/fluticasone combined with montelukast is better than of salmeterol/fluticasone in the treatment of cough variant asthma, but great importance should be attached to the occurrence of adverse events when using drug combination.

Effects of Yupingfeng Granules on Immune Function and Related Indexes of Children with Allergic Rhinitis Complicated with Bronchial Asthma / 中国药房

OBJECTIVE: To investigate the effects of Yupingfeng granules on immune function and related indexes of children with allergic rhinitis (AR) complicated with bronchial asthma (BA). METHODS: Clinical information of 101 children with AR complicated with BA during Feb. 2014-Sept. 2017 were analyzed retrospectively, and they were divided into control group (47 cases) and observation group (54 cases) according to treatment plan. Control group was given Salmeterol xinafoate and fluticasone propionate powder for inhalation through mouth, one inhalation, twice a day+Mometasone furoate nasal spray 50 μg each nostril. Observation group was additionally given Yupingfeng granules 5 g orally, 3 times a day, for consecutive 2 weeks, drug withdrawal at 2 weeks interval, recycled 3 times. Both groups received treatment for consecutive 3 months. Clinical symptom and sign scores, the levels of T-lymphocyte subgroup (CD4+, CD8+, CD4+/CD8+), IL-4, IFN-γ and IgE before and after treatment, the occurrence of ADR were observed in 2 groups. RESULTS: Before treatment, there was no statistical significance in clinical symptom and sign scores, levels of T-lymphocyte subgroup, serum levels of IL-4, IFN-γ or IgE between 2 groups (P＞0. 05). After treatment, clinical symptom and sign scores, CD4+, CD4+/CD8+, serum levels of IL-4 and IgE in 2 groups were all significantly lower than before treatment; observation group was significantly lower than control group. CD8+ and serum levels of IFN-y in 2 groups after treatment were significantly higher than before treatment; observation group was significantly higher than control group, with statistical significance (P＜0. 05). There was no statistical significance in the incidence of ADR between 2 groups (P＞0. 05). CONCLUSIONS: Yupingfeng granules can effectively improve immune function of children with AR complicated with BA, and relieve clinical symptom without increasing the occurrence of ADR.

Clinical effect of fluticasone propionate combined with noninvasive positive pressure ventilation in the emergency treatment of AECOPD / 中国基层医药

Objective To explore the clinical effect of fluticasone propionate combined with noninvasive positive pressure ventilation in the emergency treatment of AECOPD .Methods 88 AECOPD patients were selected, and they were divided into two groups by digital random method ,44 cases in each group.The control group received conventional treatment, the observation group received fluticasone propionate and noninvasive positive pressure ventilation treatment.The curative effect of the two groups was compared .Results The total effective rate of the observation group was 100.0%,which was higher than 70.5% of the control group (χ2 =10.827,P =0.000).After treatment,in the observation group,the FVC was (2.50 ±0.32)L,forced expiratory volume in one second (FEV1 ) was (1.36 ±0.20) L,the first second forced expiratory solvent percentage of predicted value ratio (FEV1%) was (51.23 ±4.32),the arterial oxygen pressure(PaO2 ) was (10.51 ±2.10) kPa,arterial partial pressure of carbon dioxide(PaCO2 ) was (5.15 ±1.19) kPa,and in the control group,the FVC was (2.00 ±0.30) L,FEV1 was (1.08 ±0.12)L,FEV1% was (40.6 ±4.03),PaO2 was (9.32 ±2.11) kPa,PaCO2 was (6.06 ±1.23) kPa,the differences between the two groups were statistically significant (t =7.940,9.192,8.102,8.920,9.920,P =0.023, 0.006,0.011,0.008,0.005).The readmission rate of the observation group was 4.5%,which was significantly lower than 13.6% of the control group (χ2 =9.298,P =0.000).Conclusion Fluticasone propionate combined with noninvasive positive pressure ventilation in the treatment of AECOPD patients can effectively improve lung function , reduce the relapse rate of the disease.

Effects of salmeterol fluticasone inhalation on pulmonary function and inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease / 中国基层医药

Objective To investigate the effect of salmeterol fluticasone inhalation on pulmonary function and inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease ( COPD ) . Methods 110 patients with acute exacerbation of asthma combined with COPD were selected and divided into observation group (55 cases) and control group (55 cases) by the random number table .The control group was given conventional treatment ,while the observation group was given salmeterol fluticasone inhalation therapy on the basis of routine treatment .The pulmonary function ,inflammatory cytokines and curative effects were compared between the two groups.Results After treatment,the FVC,FEV1,FEV1/FVC of the observation group were (2.64 ±0.45) L, (1.98 ±0.46)L and (80.42 ±6.43)％,which were significantly better than those of the control group (t=2.89, 2.59,6.27,all P<0.05),the improvement of lung function was more obvious than that of the control group (P<0.05).After treatment,the levels of TNF-α,IL-8,IL-10 and IL-17 in sputum of the observation group were (30.03 ±6.78)μg/L,(59.96 ±7.73)μg/L,(29.89 ±4.11)μg/L and (92.37 ±9.79)μg/L,respectively,which were significantly lower than those of the control group (t=7.54,6.16,7.04,12.31,all P<0.05).After treatment, the levels of TNF -α, IL -8, IL-10 and IL -17 in peripheral blood of the observation group were ( 14.08 ± 5.36)μg/L,(26.32 ±4.03)μg/L,(30.32 ±5.04)μg/L and (173.82 ±18.19)μg/L,respectively,which were significantly lower than those of the control group (t =4.26,7.95,11.25.5.31,all P<0.05).The decrease of inflammatory cytokines in sputum and peripheral blood of the observation group was more significant than that of the control group (P<0.05).The effective rate of the observation group was 94.55％,which was significantly higher than 81.82％of the control group (P<0.05).Conclusion Salmeterol fluticasone inhalation can improve patients'pulmonary function,decrease the level of inflammatory cytokines in sputum and peripheral blood ,which is worthy of clinical application and spread .

Effects of salmeterol xinafoate and fluticasone propionate powder in combination with montelukast on pulmonary function and serum inflammatory cytokines in children with cough variant asthma / 中国基层医药

Objective To investigate the therapeutic effects of salmeterol xinafoate and fluticasone propio-nate powder(seretide) in combination with montelukast on children with cough variant asthma (CVA),and its effect on pulmonary function and serum inflammatory cytokines .Methods 200 patients with CVA were enrolled ,and they were randomly divided into two groups according to the random number table ,100 cases in each group .The control group was treated with seretide ,while the observation group was treated with seretide and montelukast sodium ,both two groups were treated for 3 months.The clinical efficacy,pulmonary function and serum inflammatory cytokines were compared between the two groups .Results The total effective rate of the observation group ( 88.3％) was significantly higher than that of the control group (70.3％;χ2 =9.146,P<0.05).The duration of remission and disappearance of cough symptoms in the observation group were (5.45 ±1.32) d,(8.63 ±1.96) d,respectively, which were significantly shorter than those in the control group [(7.33 ±2.46) d,(12.61 ±1.84) d;t =6.505, 14.229,all P<0.05].There were no statistically significant differences in FEV 1,FEV1/FVC,PEF,IgE,TNF-αand IL-17 between the two groups before treatment (all P>0.05).After treatment,the levels of FEV1,FEV1/FVC, PEF were all significantly higher than those before treatment [(2.11 ±0.34) L,(73.71 ±11.44)％,(86.34 ± 7.85)％,t=18.149,7.664,19.196,all P<0.05;(1.82 ±0.35)L,(69.36 ±10.79)％,(81.66 ±8.03)％,t=9.312,5.418,13.627,all P <0.05],and IgE,TNF -α,IL -17 levels were significantly decreased [(141.3 ± 38.2)ng/L,(624.7 ±213.2) ng/L,(6.1 ±2.1) ng/L,t =15.200,13.708,15.881,all P <0.05;(191.5 ±41.9) ng/L,(835.5 ±326.3)ng/L,(9.4 ±2.7) ng/L,t=6.784,6.206,8.550,all P<0.05].The differences between the two groups were statistically significant(t=5.717,2.659,4.008,8.521,4.842,9.296,all P<0.05). Conclusion Salmeterol xinafoate and fluticasone propionate powder in combination with montelukast sodium has excellent clinical effect in the treatment of children with CVA ,which can improve the pulmonary function and reduce inflammatory cytokines .

Safety of Fluticasone Furoate Nasal spray among Filipino patients with Allergic Rhinitis: A post-marketing surveillance study

Introduction@#Allergic rhinitis (AR) is a highly prevalent chronic disease affecting up to 30% of the population worldwide.1 Although AR is not life-threatening, it greatly impacts patients’ health-related quality of life and furthermore, if left untreated, it may be complicated by other respiratory co-morbidities.2 Intranasal corticosteroids are one of the several classes of medications recommended to manage AR. Fluticasone furoate nasal spray is a novel enhancedaffinity glucocorticoid for the management of AR.2 This study assessed the safety profile of Fluticasone furoate nasal spray in the treatment of Filipino patients with AR.@*Methods@#This is a multicenter, prospective, post-marketing surveillance study aimed at documenting adverse events, their frequency and severity as assessed by the investigators among Filipino patients with AR administered with Fluticasone furoate nasal spray from August 2010 to January 2013.@*Results@#Four hundred thirty-nine (439) patients were enrolled in the study. Among these, 421 patients were included in the safety analysis population. Eighteen patients were excluded from the safety analysis population due to protocol violation and lack of post-baseline safety assessment. Of the total eligible population, 10 patients (2.4%) experienced adverse events (AEs) with a total of 10 and no serious adverse events (SAEs) were reported. Eight of these 10 AEs resolved while two AEs had unknown outcome. One patient (0.2%) experienced an AE suspected to be related to study medication. The most common AE occurring in eight patients was respiratoryrelated which were nasal dryness (3 events), rhinorrhea (2 events), epistaxis (1 event), nasal discomfort (1 event) and rhinalgia (1 event).@*Conclusion@#Fluticasone furoate nasal spray, among indicated patients with AR showed AEs which approximate AE of other similar post-marketing studies with incidence of less than 1% for each event.[21] Neither SAEs nor drugrelated deaths were reported throughout the study.

Evaluación clínica del tratamiento de la rinitis alérgica perenne con spray nasal de Fluticasona y Azelastina / Clinical evaluation of perennial allergic rhinitis treatment with Fluticasone and Azelastine nasal spray

Introducción: La azelastina es un antihistamínico tópico nasal, exento de los molestos efectos sistémicos, la cual asociada con fluticasona, ha mostrado excelentes resultados en el control de la rinitis alérgica. Objetivo: Evaluar los resultados del tratamiento del spray nasal de azelastina y fluticasona. Diseño: Observacional descriptivo prospectivo. Materiales y métodos: Se evaluaron 76 pacientes de ambos sexos, con edades entre los 12 y 59 años, con diagnóstico de rinitis alérgica en el que se midieron los síntomas: obstrucción, prurito, estornudos y rinorrea. La severidad de los síntomas fue valorada por el propio paciente de 0 a 10 pretratamiento, a la semana, dos, tres y cuatro semanas de iniciado el tratamiento, el cual fue igual para todos los pacientes, con control ambiental y la atomización de 2 puff en cada fosa nasal del spray de azelastina y fluticasona. Se hizo seguimiento de los síntomas nasales y la aparición de efectos colaterales. Resultados: Se observó una diferencia estadísticamente significativa entre el puntaje obtenido previo al tratamiento y en la evaluación posterior desde la primera semana de uso y hasta el momento del seguimiento final a la cuarta semana (p<0,0001 Friedman F). Conclusiones: El spray nasal de azelastina y fluticasona, es muy útil en el control de los síntomas de rinitis alérgica, mostrando además un adecuado perfil de seguridad.

Introduction: Azelastine, is a topical nasal antihistamine free of systemic effects, the quality associated with fluticasone, has been excellent in the control of allergic rhinitis. Objective: To evaluate the results of the treatment of the nasal spray of azelastine and fluticasone. Design: Prospective and descriptive study. Methods: 76 patients of both sexes, aged between 12 and 59 years, with a diagnosis of allergic rhinitis in which the symptoms were measured: obstruction, pruritus, sneezing and rhinorrhea. The severity of each symptom was assessed by the patient from 0 to 10 before and after a week, two, three and four weeks, which was the same for all patients, with environmental control and the atomization of 2 puffs in each nostril of the azelastine and fluticasone spray. A follow-up of nasal symptoms and the appearance of side effects. Results: A statistically significant difference was observed between the score obtained before the treatment and in the subsequent evaluation from the first week until the time of the final follow-up at the fourth week (p <0.0001 Friedman F). Conclusion: The nasal spray of azelastine and fluticasone is very useful in the control of the symptoms of allergic rhinitis.

Tiotropium bromide combined with salmeterol/fluticasone on the treatment of 122 cases with asthma COPD overlap syndrome / 中国生化药物杂志

Objective To evaluate the clinical efficacy of tiotropium combined with salmeterol/fluticasone on the treatment of the patients with asthma COPD overlap syndrome. Methods 122 patients with asthma COPD overlap syndrome were divided into 2 groups by randomized envelope, the experimental group and the control group. The experimental group were given tiotropium bromide combined with salmeterol/fluticasone. The control group were received compound ipratropium bromide combined with salmeterol/fluticasone. The clinical effect was observed. Results Before treatment, there was no significant difference in lung function between the two groups. After treatment, the improvement of pulmonary function indexes in the experimental group was significantly higher than that in the control group (P<0.05). And the number of acute attack and attack time in the experimental group were also better than those in the control group (P<0.05). Conclusion Tiotropium combined with Shah Mette Lo/fluticasone is effective on the treatment of asthma COPD overlap syndrome, and has some clinical advantages in improving lung function and reducing the frequency of attack.