A Pilot Study to Assess the Incidence of Local Oropharyngeal and Laryngeal Adverse Effects of Advair DISKUS 250/50 mcg BID as Assessed by the Development of Laryngitis and Oropharyngeal Candidiasis in Adults With Mild Persistent Asthma
概览
- 阶段
- 4 期
- 干预措施
- 未指定
- 疾病 / 适应症
- Asthma
- 发起方
- Allergy & Asthma Medical Group & Research Center
- 入组人数
- 13
- 试验地点
- 1
- 主要终点
- To determine the magnitude of change from baseline to end of study in the Voice Handicap Index (VHI) with Advair® DISKUS 250/50 mcg BID in subjects with mild persistent asthma.
- 状态
- 已完成
- 最后更新
- 2年前
概览
简要总结
This Pilot study is designed to explore the rate of local side effects of fluticasone as delivered by Advair and to determine the best outcome measure to assess these effects. This study is the initial step, and will be followed by a larger scale study.
详细描述
Asthma is a chronic inflammatory disorder of the airways. The inflammation is associated with bronchial hyperresponsiveness, airflow obstruction, and respiratory symptoms including wheezing, coughing and chest tightness. Inhaled corticosteroids are the most effective controller asthma medications. They are indicated for management of persistent asthma at all levels of severity. They have been documented to improve symptoms and pulmonary function and reduce exacerbations, need for quick-relief medications and airway hyperresponsiveness. Despite their benefits, inhaled corticosteroids have been associated with adverse local effects. These include oral candidiasis and dysphonia. However, though these risks have been reported, they have not been carefully studied. The incidence of oral candidiasis in newly treated subjects and its onset within a carefully monitored timeframe have not been adequately assessed. A more overtly undesirable effect is dysphonia. Data on it are usually collected from spontaneous reports by patients in clinical trials. However, awareness of dysphonia requires a certain degree of subjective discomfort to initiate the report. Subjective awareness of dysphonia often varies based on an individuals voice requirements. A singer, for example, is usually acutely aware of minor voice changes in contrast to someone who does not depend on voice quality. Nonetheless, voice abnormalities can probably occur with similar frequency in patients who are concerned or not concerned with their voice due to inhaled corticosteroids. New subjective scales for reporting on an individual's voice have recently been validated and published in other areas. These scales have not been validated in patients with asthma or in subjects using inhaled corticosteroids. New technologies for objective voice assessment have also been developed and these permit greater ability to quantify voice changes. These advances permit better measures of the potential adverse effects of inhaled corticosteroids on voice both with regard to onset of abnormalities and with regard to magnitude of effects. This pilot study is an initial probe into clarifying the potential of the inhaled corticosteroid, fluticasone propionate delivered in the Advair DISKUS device to produce oral candidiasis and voice changes, and to determine the best measurement to quantitate objectively that effect.
研究者
入排标准
入选标准
- •Male or Female, 18-55 years of age. Females will be eligible only if they are:
- •Surgically sterilized, post-menopausal, abstinent, or practicing adequate method of birth control, and if they have a
- •Negative urine pregnancy test (females of childbearing potential)
- •History of mild persistent asthma for at least 6 months as defined by NIH NHLBI April 19971
- •At Visit 1 (Screening) treatment for the last 30 days prior to screening must be:
- •No inhaled corticosteroid therapy. (Previous use of leukotriene receptor antagonists, and/or cromones, in addition to bronchodilators also allowed.)
排除标准
- •Female subjects who are pregnant or trying to become pregnant
- •Breast feeding
- •Current patient reported hoarseness or sore throat
- •Presence of oropharyngeal thrush (as determined by investigator examination without culture results)
- •Unresolved fungal, viral or bacterial infection elsewhere in the body
- •Viral or bacterial respiratory tract infection within the last 14 days
- •History of persistent gastro-esophageal reflux refractory to conventional treatment within the last 30 days
- •Has smoked within the previous 6 months or has greater than a lifetime 10 pack-year smoking history or regular exposure to environmental tobacco smoke
- •History of inflammatory arthritis requiring immunosuppressive or corticosteroid therapy
- •History of glaucoma, cataracts (lens opacities), retinal disease, or blindness
结局指标
主要结局
To determine the magnitude of change from baseline to end of study in the Voice Handicap Index (VHI) with Advair® DISKUS 250/50 mcg BID in subjects with mild persistent asthma.
次要结局
- 2. Inhaled Corticosteroid Questionnaire (ICQ)
- 3. Reflux Symptom Index (RSI)
- 1. Voice Related Quality of Life (VRQOL)
- 7. Signal to noise ratio
- 8. Oropharyngeal Candida species culture
- 9. Oropharyngeal Candida species related symptoms
- 4. Videostroboscopy and Determination of Reflux Finding Score (RFS)
- 5. Voice jitter
- 10. Oropharyngeal thrush on physical exam
- 6. Voice shimmer