目的系统评价环索奈德鼻喷剂治疗季节性过敏性鼻炎的临床疗效和安全性,为临床合理用药提供循证依据。方法通过检索Cochrane library、Web of Science、Pubmed、ClinicalTrials、中国知网(CNKI)、万方、维普及中国生物医学数据库(CBM),...目的系统评价环索奈德鼻喷剂治疗季节性过敏性鼻炎的临床疗效和安全性,为临床合理用药提供循证依据。方法通过检索Cochrane library、Web of Science、Pubmed、ClinicalTrials、中国知网(CNKI)、万方、维普及中国生物医学数据库(CBM),收集比较环索奈德(试验组)和安慰剂(对照组)治疗过敏性鼻炎的随机对照试验,检索时限均为从建库至2022年10月。由2位评价员按照纳入及排除标准对文献进行严格筛选,并进行质量评估,使用RevMan5.4版软件进行统计分析。结果纳入8项研究的Meta分析结果显示,环索奈德具有降低瞬时总鼻症状评分[WMD=-0.43,95%CI(-0.63,-0.23),P<0.01]、瞬时鼻腔单项评分[WMD=-0.19,95%CI(-0.23,-0.05),P<0.01]、反映性总鼻症状评分[WMD=-0.66,95%CI(-0.80,-0.52),P<0.01]、反映性鼻腔单项评分[WMD=-0.23,95%CI(-0.26,-0.21),P<0.01]、瞬时眼部单项积分[WMD=-0.19,95%CI(-0.22,-0.15),P<0.01]、瞬时眼部症状总积分[WMD=-0.28,95%CI(-0.56,-0.00),P=0.05]、反映性眼部症状总积分[WMD=-0.27,95%CI(-0.54,-0.00),P=0.05]、反映性眼部单项积分[WMD=-0.17,95%CI(-0.21,-0.14),P<0.01]、鼻结膜炎生存质量量表[WMD=-0.61,95%CI(-0.76,-0.47),P<0.01]的相关评分的作用。试验组与对照组相比,不良反应事件的发生率[OR=0.96,95%CI(0.76,1.20),P=0.72]无变化。结论环索奈德鼻喷剂对季节性过敏性鼻炎的治疗卓有成效,且不良反应事件的发生率无变化,有良好的安全性及耐受性,具有进一步临床推广的价值。展开更多
<span style="font-family:Verdana;"><strong>Introduction:</strong></span><span><span><span style="font-family:""><span style="font-family:Verda...<span style="font-family:Verdana;"><strong>Introduction:</strong></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The inflammatory mechanisms of COVID-19 suggest that corticosteroids may be beneficial, but their benefits must outweigh their potential risks. The RECOVERY trial results suggest that dexamethasone 6 mg/day </span><span style="font-family:Verdana;">(but not other steroids) may confer mortality benefits on ventilated COVID-19 </span><span style="font-family:Verdana;">patients.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This is a narrative review of the literature about the use of ciclesonide and dexamethasone for COVID-19 patients. Literature is being created rapidly and this review is offered as a state-of-the-science narration.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The SARS-CoV-2 virus is an RNA virus whose RNA is transcribed via open reading frames, making its elimination difficult. Coronaviruses have evolved multiple strategies for proteolytic activation of the spike;viral replication occurs entirely in the cytoplasm. In this connection, the RNA-cleaving endoribonuclease (NSP-15 also known as EndoU) may play a key role by facilitating viral double-stranded RNA recognition by the host’s macrophages. </span><span style="font-family:Verdana;">Furthermore, the virus is able to undergo RNA recombination rapidly,</span><span style="font-family:Verdana;"> enabling it to evade host immunity and develop drug resistance. Cicleson展开更多
Ciclesonide is a new corticosteroid currently in clinical development for the treatment of asthma by oral inhalation. The objectives of the present study were to develop ciclesonide dry powder inhalers （DPIs, 80 μg...Ciclesonide is a new corticosteroid currently in clinical development for the treatment of asthma by oral inhalation. The objectives of the present study were to develop ciclesonide dry powder inhalers （DPIs, 80 μg） and investigate the anti-asthmatic effect in animals. For preparing a ciclesonide capsule-type DPI, sphere-shaped lactose was used as a diluent carrier, mixed with micronized ciclesonide, and filled into a capsule, and then put into a dry powder inhaler for oral inhalation. The asthmatic model was established with guinea pigs, and the therapeutic efficacy of ciclesonide was performed on the asthmatic guinea pig model. Results showed that the pulmonary deposition ratio of ciclesonide DPIs was approximately 26% and their content uniformity met the requirements of China Pharmacopoeia. The established pathological model exhibited the typical features of asthma with a widened pulmonary alveolar interval, narrowed alveolar space and detached bronchial mucosal epithelium with topical necrosis, goblet cell hyperplasia, and inflammatory cell infiltration. After treating with ciclesonide, the impaired indicators in asthmatic guinea pigs were significantly recovered or alleviated, exhibiting decreased total cells, decreased eosinophils and a decreased IL-5 level while there was an increased IFN-γ level in the bronchoalveolar lavage fluid （BALF）. This study develops a new pulmonary ciclesonide delivery system for treating asthma, and proves the therapeutic efficacy in asthmatic guinea pigs.展开更多
文摘目的系统评价环索奈德鼻喷剂治疗季节性过敏性鼻炎的临床疗效和安全性,为临床合理用药提供循证依据。方法通过检索Cochrane library、Web of Science、Pubmed、ClinicalTrials、中国知网(CNKI)、万方、维普及中国生物医学数据库(CBM),收集比较环索奈德(试验组)和安慰剂(对照组)治疗过敏性鼻炎的随机对照试验,检索时限均为从建库至2022年10月。由2位评价员按照纳入及排除标准对文献进行严格筛选,并进行质量评估,使用RevMan5.4版软件进行统计分析。结果纳入8项研究的Meta分析结果显示,环索奈德具有降低瞬时总鼻症状评分[WMD=-0.43,95%CI(-0.63,-0.23),P<0.01]、瞬时鼻腔单项评分[WMD=-0.19,95%CI(-0.23,-0.05),P<0.01]、反映性总鼻症状评分[WMD=-0.66,95%CI(-0.80,-0.52),P<0.01]、反映性鼻腔单项评分[WMD=-0.23,95%CI(-0.26,-0.21),P<0.01]、瞬时眼部单项积分[WMD=-0.19,95%CI(-0.22,-0.15),P<0.01]、瞬时眼部症状总积分[WMD=-0.28,95%CI(-0.56,-0.00),P=0.05]、反映性眼部症状总积分[WMD=-0.27,95%CI(-0.54,-0.00),P=0.05]、反映性眼部单项积分[WMD=-0.17,95%CI(-0.21,-0.14),P<0.01]、鼻结膜炎生存质量量表[WMD=-0.61,95%CI(-0.76,-0.47),P<0.01]的相关评分的作用。试验组与对照组相比,不良反应事件的发生率[OR=0.96,95%CI(0.76,1.20),P=0.72]无变化。结论环索奈德鼻喷剂对季节性过敏性鼻炎的治疗卓有成效,且不良反应事件的发生率无变化,有良好的安全性及耐受性,具有进一步临床推广的价值。
文摘<span style="font-family:Verdana;"><strong>Introduction:</strong></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The inflammatory mechanisms of COVID-19 suggest that corticosteroids may be beneficial, but their benefits must outweigh their potential risks. The RECOVERY trial results suggest that dexamethasone 6 mg/day </span><span style="font-family:Verdana;">(but not other steroids) may confer mortality benefits on ventilated COVID-19 </span><span style="font-family:Verdana;">patients.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This is a narrative review of the literature about the use of ciclesonide and dexamethasone for COVID-19 patients. Literature is being created rapidly and this review is offered as a state-of-the-science narration.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The SARS-CoV-2 virus is an RNA virus whose RNA is transcribed via open reading frames, making its elimination difficult. Coronaviruses have evolved multiple strategies for proteolytic activation of the spike;viral replication occurs entirely in the cytoplasm. In this connection, the RNA-cleaving endoribonuclease (NSP-15 also known as EndoU) may play a key role by facilitating viral double-stranded RNA recognition by the host’s macrophages. </span><span style="font-family:Verdana;">Furthermore, the virus is able to undergo RNA recombination rapidly,</span><span style="font-family:Verdana;"> enabling it to evade host immunity and develop drug resistance. Cicleson
基金Tianjin Pharmaceuticals Research Organization Co.,Ltd,and in part by the Key Grant of Beijing Natural Science Foundation(Grant No.7091005)
文摘Ciclesonide is a new corticosteroid currently in clinical development for the treatment of asthma by oral inhalation. The objectives of the present study were to develop ciclesonide dry powder inhalers （DPIs, 80 μg） and investigate the anti-asthmatic effect in animals. For preparing a ciclesonide capsule-type DPI, sphere-shaped lactose was used as a diluent carrier, mixed with micronized ciclesonide, and filled into a capsule, and then put into a dry powder inhaler for oral inhalation. The asthmatic model was established with guinea pigs, and the therapeutic efficacy of ciclesonide was performed on the asthmatic guinea pig model. Results showed that the pulmonary deposition ratio of ciclesonide DPIs was approximately 26% and their content uniformity met the requirements of China Pharmacopoeia. The established pathological model exhibited the typical features of asthma with a widened pulmonary alveolar interval, narrowed alveolar space and detached bronchial mucosal epithelium with topical necrosis, goblet cell hyperplasia, and inflammatory cell infiltration. After treating with ciclesonide, the impaired indicators in asthmatic guinea pigs were significantly recovered or alleviated, exhibiting decreased total cells, decreased eosinophils and a decreased IL-5 level while there was an increased IFN-γ level in the bronchoalveolar lavage fluid （BALF）. This study develops a new pulmonary ciclesonide delivery system for treating asthma, and proves the therapeutic efficacy in asthmatic guinea pigs.
