Literature DB >> 7785003

Medium term treatment of stable stage cystic fibrosis with recombinant human DNase I.

P L Shah1, S F Scott, H J Fuchs, D M Geddes, M E Hodson.   

Abstract

BACKGROUND: A phase II multicentre double blind placebo controlled study in 1993 showed that short term treatment (10 days) with recombinant human DNase I (rhDNase) was safe and improved pulmonary function in patients with cystic fibrosis with stable stage lung disease. A six month open label treatment study was conducted in some of the patients who participated in the short term study to assess the medium term effects of rhDNase.
METHODS: Patients who completed the phase II study and were stable for 14 days prior to treatment were eligible. They were treated with rhDNase 2.5 mg twice daily for six months and reviewed at regular intervals to assess safety and efficacy.
RESULTS: Fifty nine patients (31M,28F) of age range 16-55 years were recruited. Mean baseline values for forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were 41.5% and 72.4% of predicted, respectively. The mean increase in FEV1 over the first month of treatment was 13.1% (range 12-14.1%) and then stabilised at 6.2% (4.6-7.8%) for the subsequent five months. FVC was similarly improved. Administration of rhDNase improved the severity of dyspnoea, cystic fibrosis related symptoms, and the modified Taussig/NIH score (not statistically significant). Fifty seven of the 59 patients completed the study; two died from progression of their pulmonary disease unrelated to treatment with rhDNase. The adverse events and intercurrent illnesses were no different from those expected in a cystic fibrosis population. Pharyngitis was the only possible drug related adverse event which occurred at least once in 14% of patients during the six month period.
CONCLUSIONS: Administration of rhDNase was safe, well tolerated, and improved pulmonary function in patients with cystic fibrosis. When rhDNase was stopped at day 169 there was a deterioration in pulmonary function and dyspnoea score.

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Year:  1995        PMID: 7785003      PMCID: PMC474268          DOI: 10.1136/thx.50.4.333

Source DB:  PubMed          Journal:  Thorax        ISSN: 0040-6376            Impact factor:   9.139


  14 in total

1.  Composition of tracheobronchial secretions in cystic fibrosis of the pancreas and bronchiectasis.

Authors:  W S CHERNICK; G J BARBERO
Journal:  Pediatrics       Date:  1959-11       Impact factor: 7.124

2.  Validation of a vertical visual analogue scale as a measure of clinical dyspnea.

Authors:  A G Gift
Journal:  Rehabil Nurs       Date:  1989 Nov-Dec       Impact factor: 1.625

3.  Bronchospasm after inhalation of pancreatic dornase.

Authors:  P Raskin
Journal:  Am Rev Respir Dis       Date:  1968-10

4.  A new prognostic score and clinical evaluation system for cystic fibrosis.

Authors:  L M Taussig; J Kattwinkel; W T Friedewald; P A Di Sant'Agnese
Journal:  J Pediatr       Date:  1973-03       Impact factor: 4.406

5.  Recombinant human DNase inhalation in normal subjects and patients with cystic fibrosis. A phase 1 study.

Authors:  M L Aitken; W Burke; G McDonald; S Shak; A B Montgomery; A Smith
Journal:  JAMA       Date:  1992-04-08       Impact factor: 56.272

6.  Efficacy and safety of short-term administration of aerosolised recombinant human DNase I in adults with stable stage cystic fibrosis.

Authors:  C Ranasinha; B Assoufi; S Shak; D Christiansen; H Fuchs; D Empey; D Geddes; M Hodson
Journal:  Lancet       Date:  1993-07-24       Impact factor: 79.321

7.  Effect of aerosolized recombinant human DNase on exacerbations of respiratory symptoms and on pulmonary function in patients with cystic fibrosis. The Pulmozyme Study Group.

Authors:  H J Fuchs; D S Borowitz; D H Christiansen; E M Morris; M L Nash; B W Ramsey; B J Rosenstein; A L Smith; M E Wohl
Journal:  N Engl J Med       Date:  1994-09-08       Impact factor: 91.245

8.  Efficacy and safety of short-term administration of aerosolized recombinant human deoxyribonuclease in patients with cystic fibrosis.

Authors:  B W Ramsey; S J Astley; M L Aitken; W Burke; A A Colin; H L Dorkin; J D Eisenberg; R L Gibson; I R Harwood; D V Schidlow
Journal:  Am Rev Respir Dis       Date:  1993-07

9.  Cystic fibrosis in adolescents and adults.

Authors:  A R Penketh; A Wise; M B Mearns; M E Hodson; J C Batten
Journal:  Thorax       Date:  1987-07       Impact factor: 9.139

10.  Cystic fibrosis in the United Kingdom, 1968-1988: incidence, population and survival.

Authors:  J A Dodge; S Morison; P A Lewis; E C Colest; D Geddes; G Russell; A D Jackson; B Bentley
Journal:  Paediatr Perinat Epidemiol       Date:  1993-04       Impact factor: 3.980

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  14 in total

1.  Effect of nebulised recombinant DNase on neutrophil elastase load in cystic fibrosis.

Authors:  C M Costello; C M O'Connor; G A Finlay; P Shiels; M X FitzGerald; J P Hayes
Journal:  Thorax       Date:  1996-06       Impact factor: 9.139

2.  Referral for lung transplantation: experience of a Birmingham Adult Cystic Fibrosis Centre between 1987 and 1994.

Authors:  P J Ryan; D E Stableforth
Journal:  Thorax       Date:  1996-03       Impact factor: 9.139

Review 3.  The role of recombinant human DNase in the treatment of patients with cystic fibrosis: many promises, more problems.

Authors:  M S Zach
Journal:  Thorax       Date:  1996-07       Impact factor: 9.139

4.  rhDNase in cystic fibrosis.

Authors:  S P Range; A J Knox
Journal:  Thorax       Date:  1995-04       Impact factor: 9.139

5.  Dornase alfa for cystic fibrosis. Evidence supporting use of this drug has not yet been published.

Authors:  J Collier
Journal:  BMJ       Date:  1995-06-10

Review 6.  Cystic fibrosis lung disease: genetic influences, microbial interactions, and radiological assessment.

Authors:  Samuel M Moskowitz; Ronald L Gibson; Eric L Effmann
Journal:  Pediatr Radiol       Date:  2005-05-03

Review 7.  Timing of dornase alfa inhalation for cystic fibrosis.

Authors:  Ruth Dentice; Mark Elkins
Journal:  Cochrane Database Syst Rev       Date:  2016-07-26

8.  Targeting of dornase alpha therapy in adult cystic fibrosis.

Authors:  M J Ledson; Z Wahbi; R P Convery; C Cowperthwaite; D P Heaf; M J Walshaw
Journal:  J R Soc Med       Date:  1998-07       Impact factor: 5.344

Review 9.  Treatment of Pulmonary Disease of Cystic Fibrosis: A Comprehensive Review.

Authors:  Rosa María Girón Moreno; Marta García-Clemente; Layla Diab-Cáceres; Adrián Martínez-Vergara; Miguel Ángel Martínez-García; Rosa Mar Gómez-Punter
Journal:  Antibiotics (Basel)       Date:  2021-04-23

10.  Timing of dornase alfa inhalation for cystic fibrosis.

Authors:  Ruth Dentice; Mark Elkins
Journal:  Cochrane Database Syst Rev       Date:  2021-03-09
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