哮喘临床防治的新观点和GINA2006解读课件.pptVIP

* * START is the acronym for ‘inhaled Steroid Treatment As Regular Therapy in early asthma’. This reminder helps us to focus on the key features of the study. It is global, 5 year longitudinal study of early intervention in the real world setting. The design is unique: it allows us to study early intervention in asthma using a DBRCT design and yet at the same time, because of the real world-setting , it is also an improvement of care study. * The point being made by this slide is that Symbicort single inhaler therapy (SSIT) or Symbicort maintenance and reliever therapy (SMART) is different from any other adjustable approach such as SAMD, GOAL or the Sont and Green studies which were all dependent on a complex algorithm to adjust maintenance treatment. With SMART adjustment becomes automatic based on the need for reliever * The number of exacerbations was lowest in the Symbicort AMD group and the profile of the exacerbation shown by rescue occasions with a SABA suggested that these reduced number of exacerbations were on average slightly milder in nature than in both fixed treatment groups. * Most patients in the clinical trial program were adult patients (approximately 4000 patients, data not shown) around 1 in 5 patients studied were in the age ranges shown above. This slide shows that severe exacerbations are reduced in all age groups versus fixed dose budesonide alone (this was dosed at 320 to 640mcg/day depending on the study). Symbicort SIT also reduced severe exacerbation rates versus fixed Symbicort (160/9mcg per day) in children and adolescents but the trend for improvement failed to reach significance in the elderly age group primarily due to a lack of study power in this subgroup. The benefit of Symbicort Single Inhaler Therapy was striking in the younger patients resulting in over a 70% reduction in exacerbations in children and adolescents. In children the data confirmed what all other studies have already shown with LABAs, i.e. that adding fixe