INTRODUCTION: Little is known about the optimal timing of rhDNase nebulization in relation to airway clearance therapy (ACT). OBJECTIVE: To compare the effects of rhDNase before ACT versus rhDNase after ACT in children with CF. DESIGN: randomized, double blind, double dummy, cross over study. INCLUSION CRITERIA: CF, stable clinical condition, rhDNase maintenance therapy. Children in Group I inhaled rhDNase 30 minutes before ACT, and placebo directly after ACT in week 1-3. The protocol was reversed during week 4-6. Group II performed the reversed sequence. Patients continued their daily routine ACT. Primary endpoint: MEF(25) %pred. Pulmonary functions tests were performed on days 0, 14, 21, 35 and 42. In weeks 3 and 6 children scored cough and sputum production on daily diary cards. RESULTS:24 patients completed the study. Mean age = 12 years (range 7-19). Mean MEF(25) %pred was 5.8% higher after 3 weeks of rhDNase before ACT, compared to rhDNase after ACT (58.3% vs 52.5%, p=0.01). There were no significant differences for any of the other variables. CONCLUSION: Inhalation of rhDNase before ACT improves peripheral airway patency in children with cystic fibrosis. Since all children were already on maintenance rhDNase therapy before the study, this effect is additional to any existing effect of regular rhDNase.
RCT Entities:
INTRODUCTION: Little is known about the optimal timing of rhDNase nebulization in relation to airway clearance therapy (ACT). OBJECTIVE: To compare the effects of rhDNase before ACT versus rhDNase after ACT in children with CF. DESIGN: randomized, double blind, double dummy, cross over study. INCLUSION CRITERIA: CF, stable clinical condition, rhDNase maintenance therapy. Children in Group I inhaled rhDNase 30 minutes before ACT, and placebo directly after ACT in week 1-3. The protocol was reversed during week 4-6. Group II performed the reversed sequence. Patients continued their daily routine ACT. Primary endpoint: MEF(25) %pred. Pulmonary functions tests were performed on days 0, 14, 21, 35 and 42. In weeks 3 and 6 children scored cough and sputum production on daily diary cards. RESULTS: 24 patients completed the study. Mean age = 12 years (range 7-19). Mean MEF(25) %pred was 5.8% higher after 3 weeks of rhDNase before ACT, compared to rhDNase after ACT (58.3% vs 52.5%, p=0.01). There were no significant differences for any of the other variables. CONCLUSION: Inhalation of rhDNase before ACT improves peripheral airway patency in children with cystic fibrosis. Since all children were already on maintenance rhDNase therapy before the study, this effect is additional to any existing effect of regular rhDNase.
Authors: Brenda M Button; Christine Wilson; Ruth Dentice; Narelle S Cox; Anna Middleton; Esta Tannenbaum; Jennifer Bishop; Robyn Cobb; Kate Burton; Michelle Wood; Fiona Moran; Ryan Black; Summar Bowen; Rosemary Day; Julie Depiazzi; Katherine Doiron; Michael Doumit; Tiffany Dwyer; Alison Elliot; Louise Fuller; Kathleen Hall; Matthew Hutchins; Melinda Kerr; Annemarie L Lee; Christina Mans; Lauren O'Connor; Ranjana Steward; Angela Potter; Tshepo Rasekaba; Rebecca Scoones; Ben Tarrant; Nathan Ward; Samantha West; Dianne White; Lisa Wilson; Jamie Wood; Anne E Holland Journal: Respirology Date: 2016-04-18 Impact factor: 6.424
Authors: Kurtis T Sobush; Courtney D Thornburg; Judith A Voynow; Stephanie D Davis; Stacey L Peterson-Carmichael Journal: J Med Case Rep Date: 2013-07-26