课件：快速持久安全雷诺考特.ppt

快速起效 持久抗炎,RE-1011-RH-0251 有效期至2011年12月止,鼻用激素在变应性鼻炎中的治疗地位,变应性鼻炎：阶梯治疗推荐 (ARIA 2008) 中重度有持续性症状患者 首选鼻用激素、H1阻滞剂或LTRA 治疗2-4周后复查，如无改善可提高鼻用激素剂量 中重度有间歇性症状或轻度有持续性症状患者 可选的药物：口服H1阻滞剂、或鼻内H1阻滞剂和/或减充血剂、或鼻用激素、或LTRA(或色酮) 持续性鼻炎治疗2-4周后复查，如无改善可提高剂量,Bousquet J, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update (in collaboration with the World Health Organization, GA2LEN and AllerGen)Allergy 2008; 63(suppl 86):8-160.,鼻用激素的总体疗效好于其他类型的药物,+改善轻微 +改善非常显著(自然暴露条件下),Cauwenberge PV, et al. Consensus statement on the treatment of allergic rhinitis. Allergy 2000; 55(2):116-134.,安全篇,持久篇,快速篇,布地奈德快速起效，仅需3小时,*相关文献中提到的最早时间,Reichmuth D, et al. Present and Potential Therapy for Allergic Rhiniti. BioDrugs 2000; 14(6):371-387.,雷诺考特3小时起效， 改善鼻塞显著优于安慰剂,Day JH, et al. Onset of action of intranasal budesonide (Rhinocort Aqua) in seasonal allergic rhinitis studied in a controlled exposure model. J Allergy Clin Immunol 2000; 105:489-494.,雷诺考特*起效迅速，显著优于糠酸莫米松,Bende M, et al. A randomized comparison of the effects of budesonide and mometasone furoate aqueous nasal sprays on nasal peak flow rate and symptoms in perennial allergic rhinitis. Ann Allergy Asthma Immunol 2002; 88:617-623.,安全篇,持久篇,快速篇,鼻用激素的受体亲和力 临床疗效,指出： 没有证据显示 糖皮质激素效能与临床疗效有线性关系 没有证据显示 受体亲和力最高的化合物临床疗效最好,2008年过敏学杂志 综述文章,* 相对于地塞米松而言的受体亲和力,Derendorf H and Meltzer EO. Molecular and clinical pharmacology of intranasal corticosteroids: clinical and therapeutic implicationsAllergy 2008; 63:1292-1300.,布地奈德具有独特的酯化作用，抗炎更持久,有效维持局部药物浓度,Brattsand R, et al. The Role of Intracellular Esterification in Budesonide Once-Daily Dosing and Airway Selectivity. Clin Ther 2003; 25:C28-C41.,雷诺考特作用时间长于丙酸氟替卡松,Petersen H, et al. Nasal retention of budesonide and Fluticasone in man: Formation of airway mucosal budesonide-esters in vivo. Br J Clin Pharmacol 2001; 51:159-163.,雷诺考特持续改善鼻塞显著优于糠酸莫米松,*与安慰剂相比，P0.01,P0.05,*,*,*,P0.05,*,Bende M, et al. A randomized comparison of the effects of budesonide and mometasone furoate aqueous nasal sprays on nasal peak flow rate and symptoms in perennial allergic rhinitis. Ann Allergy Asthma Immunol 2002; 88:617-623.,2019/8/22,13,可编辑,安全篇,持久篇,快速篇,布地奈德：亲脂性适中，对全身影响更小,Lipworth and Jackson. Safety of Inhaled and Intranasal Corticosteroids. Drug Safety 2000; 23(1):11-33.,持续使用雷诺考特一年对患儿身高发育无明显影响,Murphy K, et al. Growth velocity in children with perennial allergic rhinitis treated with budesonide aqueous nasal spray. Ann Allergy Asthma Immunol 2006; 96:723-730.,雷诺考特不含有害辅料,1. Hofmann T, et al. Influence of Preservatives and Topical Steroids on Ciliary Beat Frequency In Vitro. Arch Otolaryngol Head Neck Surg 2004; 130(4):440-445.,雷诺考特防腐剂为山梨酸钾，不抑制鼻纤毛运动,Hofmann T, et al. Influence of Preservatives and Topical Steroids on Ciliary Beat Frequency In Vitro. Arch Otolaryngol Head Neck Surg 2004; 130(4):440-445.,布地奈德：FDA批准的唯一孕期B类糖皮质激素,FDA对糖皮质激素的孕期分类： B：动物生殖实验阴性，无人体资料阳性或动物实验阳性，但大量的人体临床应用数据阴性 C：动物生殖实验阳性，无充分人体数据，或孕妇使用能获益,Herman H, et al. Once-daily administration of intranasal corticosteroids for allergic rhinitis: A comparative review of efficacy, safety, patient preference, and cost. Am J Rhinol 2007; 21(1):70-79.,1995-1997年间瑞典99%孕妇的统计调查结果：孕早期使用布地奈德不增加先天畸形发生率，与普通人群相比无显著统计学差异。 孕期B类：动物实验阴性，无人体资料。或动物实验阳性，但大量的人体临床应用数据阴性。,先天畸形发生率： 孕早期用药布地奈德相比普通孕妇无显著差异,Herman H, et al. Once-daily administration of intranasal corticosteroids for allergic rhinitis: A comparative review of efficacy, safety, patient preference, and cost. Am J Rhinol 2007; 21(1):70-79. Guidance for Industry. Establishing Pregnancy Exposure Registries. U.S. Department of Health and Human Services. Food and Drug Administration. Center for Drug Evaluation and Research (CDER). Center for Biologic Evaluation and Research (CBER). August 2002 Clinical/Medical.,雷诺考特治疗费用低,MIMS中国药品手册2010年.,鼻用糖皮质激素推荐剂量的治疗费用,快速抗炎 告别鼻塞,快速起效 持久抗炎1,2,唯一拥有鼻息肉适应症的鼻内激素3,4,5,治疗费用低7,1. Creticos P, et al. Intranasal Budesonide Aqueous Pump Spray Rhinocort Aqua) for the Treatment of Seasonal Allergic RhinitisAllergy Asthma Proc 1998; 19(5):285-294. 2. Day JH, et al. Onset of action of intranasal budesonide (Rhinocort Aqua) in seasonal allergic