기관지 천식 환자에서 플루티카손 프로피오네이트의 치료효과

다국어 초록 (Multilingual Abstract)

Background: Asthma has been recognized to be a chronic inflammatory disease. Corticosteroids are the most effective antiinflammatory drugs for the treatment of asthma. Inhaled corticosteroids have become the first line therapy for the treatment of all stages of asthma due to their direct effect on target organ. Recently, Fluticasone Propionate as a new inhaled corticosteroid with a potent topical activity and minimal side effects has been developed. Objectives. The purpose of this study was to assess the efficacy and safety of Fluticasone Propionate aerosol in the treatment of asthma. Method: Thirty patients with asthma took part in this study. Five patients were excluded due to poor compliance. All of the patients had stable asthma under their medications and nine patients had demonstarated reversibility in FEV1 to inhaled salbutamol of at least 15% after 200ug or 20% after 400ug. Patients receiving treatment with oral antiasthmatic drug except steroids retained these medications unchanged through the study. Fluticasone Propionate aerosol 250ug twice daily was given for 4 weeks to asthmatic patients. We compared daily symptom score, peak expiratory flow rate (PEF) and its diurnal variability, the frac- tion of days of additiona! Bronchodilator required to relieve asthma symptoms, and FEV1 between period of run in and treatment. Results. 1. Mean morning and night PEF significantly improved following Fluticasone Propionate(Flixotide, FP) treatment(412.9+ 21.3, 429.5+ 21.6 L/min in the 2 weeks and 4 weeks treatment period vs 356.0+19.2L/ min run in period;422.9+21.4, 440.5+22.2 L/min in the 2 weeks and 4 weeks treatment period vs 393.9+22.0 L/min run in period). Diurnal variability of PEF significantly reduced during 2 weeks and 4 weeks treatment period respectively(3.56+0.76%, 3.76 +0.93%) compared with run in peroid(22.5+ 2.5% ). 2. Mean forced expiratory volume in 1 second(FEV1) improved after 2 weeks and 4 weeks FP treatment compared with run in period(87.7+ 3.8%, 87.4+ 3.8% pred. After treatment vs 75.8+ 2.7% pred. Before treatment, p<0.01). 3. Mean daytime symptom scores after 2 weeks and 4weeks more significantly declined after treatment than run in period (0.20+0.06, 0.14+0.06 vs 0.44+0.07). Mean nighttime symptom scores more significantly declined after 2 weeks and 4 weeks treatment than run in period(0.11+0.06, 0.20+0.05 vs 0.53+0.12)(p<0.01). 4. The fraction of days required for salbutamol use to treat day symptoms significantly decreased in the four weeks treatment compared with run in period(85.9+6. 3% vs 62.4+7.6%). The fraction of nights required for salbutamol use to treat night symptoms significantly decreased in the two and four weeks treatment compared with run in period(92.2+ 4.24, 86.9+ 4.2% vs 71.3+ 6.3% ). 5. No significant differences between run in and treatment period were obseved in blood pressure, pulse rate, other laboratory examintions. And there were few adverse events including nausea, throat discomfort, voice change during FP treatment. Conclusion. This study suggests that Fluticasone Propionate(Flixotide ) at a dosage 500ug/day by metered dose inhaler(MDI) provide effective and safe treatment for asthma.