Оценка эффективности комбинированной терапии фликсотидом и серевентом у больных бронхиальной астмой

Current study present results of comnblned treatment with fluticasone propionate and salmeterol in 52 patients with moderate persistent asthma (11 male, 41 female), who received inhaled steroids for more than 3 month before study and/or in combination with different brochodilators.Efficacy of the treatment (fluticasone — 250 meg, salmeterol — 50 meg) during 9 weeks was evaluated by clinical observation, peak flow and flow-volume measurement with reversibility response to pronchodilators and daily needs to short acting β2-agonists.Obtained results demonstrated that administration of ccombined therapy with fluticasone and salmeterol the optimal way of treatment of patients according to efficacy and security. This treatment provide stabile and long-term effect on bronchial contuctance and daily variability and support its efficacy during whole treatment period. Combined administration of fluticasone and salmeterol doesn’t have serious systemic and cardiotoxic side effects.В работе представлены результаты сочетанного применения ингаляционного стероида флутиказона пропионата (ФП) и сальметерола у 52 амбулаторных больных (11 мужчин и 41 женщина) бронхиальной астмой среднетяжелого течения, изначально принимавших средние дозы ингаляционных глюкокортикостероидов (1000— 1600 мкг будесонида или 500—800 мкг ФП в сутки) в сочетании с бронхолитиками различных классов и р2-агонисты короткого действия.Эффективность комбинированного назначения дозированных ингаляций 250 мкг ФП и 50 мкг сальметерола в течение 9 недель (два раза в сутки) оценивалась на основании результатов клиникофункционального обследования пациентов: пикфлоуметрия, регистрация показателей кривой потокобъем форсированного выдоха с бронходилатационной пробой на обратимость и суточной потребности в β2-агонистах.Полученные данные продемонстрировали, что назначение сочетанной терапия ФП и сальметролом является наиболее оптимальным способом лечения больных с точки зрения эффективности и безопасности; позволяет достигнуть устойчивого и долговременного контроля бронхиальной проводимости и суточной вариабельности; сохраняет эффективность на протяжении длительного курса лечения; не обладает побочным системным и кардиотоксическим воздействием и не вызывает серьезных побочных эффектов

Randomized Trial of Oral Teriflunomide for Relapsing Multiple Sclerosis

Abstract BACKGROUND: Teriflunomide is a new oral disease-modifying therapy for relapsing forms of multiple sclerosis. METHODS: We concluded a randomized trial involving 1088 patients with multiple sclerosis, 18 to 55 years of age, with a score of 0 to 5.5 on the Expanded Disability Status Scale and at least one relapse in the previous year or at least two relapses in the previous 2 years. Patients were randomly assigned (in a 1:1:1 ratio) to placebo, 7 mg of teriflunomide, or 14 mg of teriflunomide once daily for 108 weeks. The primary end point was the annualized relapse rate, and the key secondary end point was confirmed progression of disability for at least 12 weeks. RESULTS: Teriflunomide reduced the annualized relapse rate (0.54 for placebo vs. 0.37 for teriflunomide at either 7 or 14 mg), with relative risk reductions of 31.2% and 31.5%, respectively (P<0.001 for both comparisons with placebo). The proportion of patients with confirmed disability progression was 27.3% with placebo, 21.7% with teriflunomide at 7 mg (P=0.08), and 20.2% with teriflunomide at 14 mg (P=0.03). Both teriflunomide doses were superior to placebo on a range of end points measured by magnetic resonance imaging (MRI). Diarrhea, nausea, and hair thinning were more common with teriflunomide than with placebo. The incidence of elevated alanine aminotransferase levels ( 651 times the upper limit of the normal range) was higher with teriflunomide at 7 mg and 14 mg (54.0% and 57.3%, respectively) than with placebo (35.9%); the incidence of levels that were at least 3 times the upper limit of the normal range was similar in the lower- and higher-dose teriflunomide groups and the placebo group (6.3%, 6.7%, and 6.7%, respectively). Serious infections were reported in 1.6%, 2.5%, and 2.2% of patients in the three groups, respectively. No deaths occurred. CONCLUSIONS: Teriflunomide significantly reduced relapse rates, disability progression (at the higher dose), and MRI evidence of disease activity, as compared with placebo. (Funded by Sanofi-Aventis; TEMSO ClinicalTrials.gov number, NCT00134563.)

Randomized trial of oral teriflunomide for relapsing multiple sclerosis

Teriflunomide is a new oral disease-modifying therapy for relapsing forms of multiple sclerosis