Addition of salmeterol versus doubling the dose of beclomethasone in children with asthma

被引:156
作者
Verberne, AAPH
Frost, C
Duiverman, EJ
Grol, MH
Kerrebijn, KF
Raaymakers, JAM
Pocock, SJ
Bogaard, JM
van Nierop, JC
Nagelkerke, AF
Thio, B
Schouten, TJ
van Essen-Zandvliet, EEM
Denteneer, A
Gerritsen, J
Grol, MJ
Roorda, RJ
Hendriks, JJE
Duiverman, EJ
Kouwenberg, JM
van der Laag, J
Brackel, HJL
机构
[1] Sophia Childrens Univ Hosp, Univ Hosp, Dept Pediat, Subdiv Pediat Resp Med, NL-3015 GJ Rotterdam, Netherlands
[2] Erasmus Univ, Dept Pediat, Subdiv Pediat Resp Med, Rotterdam, Netherlands
[3] Univ London London Sch Hyg & Trop Med, Dept Epidemiol & Populat Sci, Med Stat Unit, London WC1E 7HT, England
[4] Juliana Childrens Hosp, The Hague, Netherlands
[5] Univ Groningen Hosp, Beatrix Children Clin, Groningen, Netherlands
关键词
D O I
10.1164/ajrccm.158.1.9706048
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Studies in adults revealed that addition of salmeterol to a moderate dose of inhaled corticosteroid resulted in better symptom control and higher PEF compared with doubling the dose of inhaled corticosteroid. The aim of this three group study was to compare the effects of a moderate dose of beclomethasone, the same dose of beclomethasone with salmeterol, and a doubling dose of beclomethasone on lung function and symptoms in children with moderate asthma. A total of 177 children already treated with inhaled corticosteroids, were randomized in a double-blind parallel study either to salmeterol 50 mu g twice daily (BDP400+salm), beclomethasone 200 mu g twice daily (BDP800), or placebo (BDP400) in addition to beclomethasone 200 mu g twice daily. No significant differences between groups were found in FEV1, PD20 methacholine, symptom scores, and exacerbation rates after 1 yr. Salmeterol resulted in slightly better PEF in the first months of treatment. FEV1, and PD,, methacholine significantly improved in all groups. After 1 yr mean changes in FEV,, percent predicted were 4.3% (95% CI 1.3; 7.2), 5.8% (95% CI 2.9; 8.7), and 4.3% (95% CI 2.1; 6.5) for BDP400+salm, BDP800, and BDP400, respectively. Changes in airway responsiveness were 0.60 (95% CI 0.05; 1.14), 1.30 (95% CI 0.73; 1.87), and 0.80 (95% CI 0.33; 1.27) doubling doses. Growth was significantly slower in the BDP800 group. We conclude that no additional benefit was found of adding either salmeterol or more beclomethasone to a daily dose of 400 mu g beclomethasone in this group of children with excellent compliance of medication.
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收藏
页码:213 / 219
页数:7
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