过敏性鼻炎及其对哮喘的影响课件.pptVIP

* * * Slide 18 The study described on the previous slide also demonstrated a strong linear correlation between eosinophilia in the nasal mucosa and in the bronchial mucosa of asthmatic patients (r=0.851, p0.001). The airway epithelium in patients with asthma therefore appears to be inflamed all along its length, further supporting the hypothesis that asthma and rhinitis are part of the same spectrum.34 Ref 34, p 665, C2, ?4, L9-14, p 667, C1, ?1, L1-8 * * * Slide 22 The clinical link between allergic rhinitis and asthma is further supported by the effectiveness of the antileukotriene agent montelukast on endpoints of both diseases. With the exception of oral and systemic steroids administered for the most severe allergic and asthmatic cases, antileukotrienes such as montelukast represent the only class of agents indicated for the treatment of both disorders. As shown on this slide, montelukast significantly improved lung function versus placebo (p0.001) over 12 weeks of therapy in a large-scale double-blind, placebo-controlled, multicenter trial.37 In a multicenter, double-blind, randomized study in 1302 adults with spring allergic rhinitis, treatment with montelukast consistently improved the clinical endpoints associated with allergic rhinitis, including daytime nasal symptoms (congestion, rhinorrhea, pruritus, and sneezing) (p0.001 vs. placebo); nighttime symptoms (sleep difficulty, nighttime awakenings, congestion on awakening) (p=0.002 vs. placebo), and daytime eye symptoms (tearing, pruritus, redness, puffiness) (p?0.001 vs. placebo). Additionally, montelukast significantly improved rhinoconjunctivitis quality of life (p0.02 vs. placebo).38 Montelukast also significantly reduced peripheral blood eosinophil counts (p?0.001), suggesting that this leukotriene receptor antagonist may have systemic beneficial effects on allergic inflammation.39 Ref 1, pp 12-13, Fig 3 Ref 15, pp 15-16 Source A (WPC), p 1, Indications Ref 37, p 1217, Fig 2 Ref