Résumé
Background: The objective of the present study was to compare the efficacy and adverse effects of ciclesonide with that of budesonide and beclomethasone dipropionate in moderate persistent cases of bronchial asthma.Methods: This was an open label, randomized parallel group study done in Government General and Chest Hospital, Hyderabad for a period of 12 weeks. Each group had 20 patients. Group A was given ciclesonide inhalational therapy 160 mcg once daily. Group B was given budesonide inhalational therapy 400 mcg twice daily. Group C was given beclomethasone dipropionate inhalational therapy 400 mcg twice daily.Results: Symptomatic improvement was observed in all three groups. At end point, mean FEV1 in ciclesonide treatment group improved by 23.84% compared with 15.24% in budesonide and 12.93% in beclomethasone treatment groups. At end point, mean FVC value in ciclesonide treatment group improved by 6.44% compared with 1.5% in budesonide and 1.06% in beclomethasone groups. Mean FEV1/FVC also improved by 16.56% in ciclesonide group compared with 13.68% in budesonide and 11.93% in beclomethasone groups. No adverse effects were reported in any of the treatment groups.Conclusions: This study showed that ciclesonide is superior to budesonide and beclomethasone in improving lung function, decreasing symptoms and need for rescue medication in moderate persistent asthma.
Résumé
OBJECTIVE:To compare the clinical efficacy and safety of salmeterol-fluticasone alone versus fluticasone propio-nate combined with montelukast sodium in the treatment of children with moderate persistent asthma. METHODS:275 children with moderate persistent asthma were randomly divided into inhaled corticosteroids(ICS)+ long acting β2 receptor agonist(LABA) group (139 cases) and ICS+ leukotriene receptor antagonists (LTRA) group (136 cases). ICS+LABA group was given Salmeter-ol-fluticasone powder inhalant,1 inhalation,bid;ICS+LTRA was given Fluticasone propionate inhalation aerosol,bid+Montelu-kast sodium chewable tablet 5 mg,before bedtime,qd. Both groups received more than 12 weeks of treatment. Body indexes of 2 groups were observed after treatment,such as asthma control degree,asthma score,the percentage of peak expiratory flow(PEF) in estimated value,aberration rate of PEF,the levels of eosinophi cationic protein(ECP)and leukotrienes E4(LTE4)in peripheral blood,the times of taking short acting β2 receptor agonist (SABA) during treatment,asymptomatic days,compliance,the inci-dence of ADR,etc. RESULTS:Total effective rate of ICS+LABA group(86.33%)after 4 weeks treatment was higher than that of ICS+LTRA group(58.09%),with statistical significance(P0.05). The day and night asthma score of 2 groups decreased significantly and the percentage of PEF in estimated value increased significantly after treatment,there was statisti-cal significance compared to before treatment(P0.05). The levels of ECP and LTE4 decreased significantly in 2 groups after treatment,there was statistical signif-icance compared to before treatment(P0.05). CONCLUSIONS:Salmeterol-fluticasone alone versus fluticasone propionate combined with montelukast sodi-um in the treatment of children with moderate persistent asth-ma both have good therapeutic efficacy and safety,while thelatter one has stronger inhibition effect on ECP and LTE4,and to control asthma symptoms more rapidly.
Résumé
Background: The objective of this study was to compare the safety and efficacy of tiotropium bromide with salbutamol in moderate persistent cases of bronchial asthma at tertiary care hospital. Methods: This was an open label, randomized parallel group study done in Government General Hospital, Srikakulam for a period of 12 weeks. Group-1 was given tiotropium bromide metered dose inhalational therapy 18mcg once daily in 50 patients. Group-2 was given salbutamol metered dose inhalational therapy 100mcg thrice daily in 30 patients. Results: Symptomatic improvement was observed in l two groups. At end point, mean FEV1 in tiotropium bromide treatment group improved by 149.96% compared with 135.16% salbutamol treatment group. At end point, mean FVC value in tiotropium bromide treatment group improved by 145.71% compared with 122.34% in salbutamol group. Mean FEV1 / FVC also improved by 155.41% in tiotropium bromide group compared with 105.41 % in salbutamol group. Conclusion: The present study proved tiotropium provide superior safety and efficacy relative to control drug in bronchial asthma patients in both clinical assessment score and spirometrically.
Résumé
Background: Steroid, bronchodilator and the leukotriene receptor antagonist montelukast have demonstrated efficacy in children with mild persistent asthma, but comparative long-term studies in adult patient with moderate persistent asthma is needed. A randomized and prospective study was undertaken to find out the efficacy of montelukast as add on to β2-agonist and inhaled corticosteroids in patients of moderate persistent asthma. Methods: This was a continuous, longitudinal, prospective study carried out at a tertiary care teaching hospital. Newly diagnosed patients of moderate persistent asthma attending the chest out patient department (OPD) were enrolled. Group I was treated with salbutamol 200 mcg rotacap SOS and formoterol 6 mcg + budesonide 400 mcg rotacap BD. In addition to these medicines group II also received montelukast 10 mg OD. The patients were followed up every two months. Clinical examination and pulmonary function tests (PFT) were carried out at baseline and during each visit. Unpaired ‘t’ test was used for statistical analysis. Results: Comparison of clinical symptoms revealed a better improvement in group II as compare to group I [cough - 83% vs. 33%; breathlessness - 75% vs. 33%; and wheezing - 83% vs. 78%] at the end of one year. A significantly better (p < 0.05) improvement in forced expiratory volume (FEV1) was also observed in group II. Conclusions: Treatment with montelukast leads to better improvement in clinical symptoms and PFT in the patients of moderate persistent asthma.
Résumé
This study aimed to evaluate effect of proton pump inhibitor (esomeprazole) on asthma symptoms, use of inhaled bronchodilator and peak expiratory flow rate (PEFR) in moderate persistent asthma with gastroesofageal refluks disease (GERD). This randomized single blind, controlled clinical trial study was conducted at Persahabatan Hospital, Jakarta from July 2004 until October 2005. Samples were moderate persistent asthma patients with GERD. GERD is diagnosed GERD symptoms and proof of oesophagitis from endoscopy and or histapatologic examination from oesophagus biopsy. Phase 1:2 week run-in period patient received inhaled budesonide 2x200 ug/day. Phase 2: patient randomised to receive inhaled budesonide 2 x 400 ug/day with esomeprazole 40 mg/day or without esomeprazole (control group) for 8 weeks. Phase 3: 4 week wash out period, patient receive inhaled budesonide 2 x 200 ug/day. Diary cards were assessed at run-in periode, after treatment 4 weeks, 8 weeks and wash out. There were 32 patients (23 female and 9 male) completed the study. Mean total asthma symptoms score daily were significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-2.29 vs -0.90; p < 0.05). Mean use of inhaled bronchodilator was significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-1.09 vs -0.42; p < 0.05). Morning and evening PEFR improved higher on esomeprazole than without esomeprazol but were not significantly difference. In conclusion, administration esomeprazole 40 mg daily improved asthma symptoms and lower the use of inhaled bronchodilator in moderate persistent asthma patients with GERD.