from: http://www.qqyy.com/jibing/erbihouke/111020/3fd2f.html
http://www.chemdrug.com/news/231/5/24943.html
http://www.brodnermd.com/propel-sinus-implants.html
据悉,美国食品和药物管理局(FDA)已批准新颖的糠酸莫米松植入式给药系统,为慢性鼻窦炎患者提供控释给药。
该设计是首个直接对鼻窦黏膜控制性给予类固醇药物的产品。一旦通过内窥镜手术植入,生物可吸收性的药物释放支架扩张撑开筛窦确保通畅。
在各种鼻窦炎中,上颌窦炎最多见,依次为筛窦、额窦和蝶窦的炎症。鼻窦炎可以单发,亦可以多发。最常见的致病原因为鼻腔感染后继发鼻窦化脓性炎症。鼻窦炎在治疗上一直困扰很多人,最近FDA表示,鼻窦炎治疗将迎来新希望。
据该公司的新闻稿,FDA的批准是基于3项在美国开展的前瞻性临床试验(N = 205),其中包括随机、双盲先导研究(ADVANCE安全性研究)和随机、双盲ADVANCE临床试验。后者的研究结果将在于2011年9月11日至 14日在加利福尼亚州旧金山召开的美国耳鼻咽喉-头颈外科学会年会上公布。
这些临床试验的数据表明,使用该设备可防止手术后筛窦的阻塞,从而改善手术的结果和降低另外的操作和全身性给予类固醇相关不良事件的几率。
在一项纳入43例患者的研究中(Int Forum Allergy Rhinol. 2011;1:23-32),与对照支架相比,使用莫米松洗脱支架在21-45天时炎症显著减轻(P < 0.003) ,息肉形成的频率下降(P = 0.0391),使粘连最小化(P = 0.0313)。没有报告设备相关不良事件,也没有肾上腺皮质抑制的证据。
在新闻发布会上,David W. Kennedy博士说,这种创新性的产品获得FDA批准对于[耳朵、鼻子和咽喉] 临床医生和患者是一个好消息,(莫米松的植入)在手术后期间减少了炎症和疤痕的发生。因此,它有望显著改善鼻窦手术的长期结果,正如多项研究已经显示的结果,减少了疤痕和炎症,这与不需要进一步进行手术相关。我相信微创技术和局部给药将是未来鼻窦治疗的主流。
Kennedy博士是费城宾夕法尼亚卫生系统大学耳鼻咽喉科教授。
其他的糠酸莫米松制剂已经在美国销售用于治疗各种疾病。
On August 15, 2011 – Intersect ENT, Inc., an innovator in treatment alternatives for
ear, nose and throat clinicians and patients announced that the U.S. Food and Drug
Administration (FDA) had approved the company’s Propel™ mometasone furoate implant offering localized, controlled drug delivery for chronic sinusitis patients.
According to David W. Kennedy, M.D., F.A.C.S., professor of Otorhinolaryngology at the University of
Pennsylvania Health System in Philadelphia, PA, a widely recognized pioneer in functional
endoscopic sinus surgery. “Propel reduces the occurrence of inflammation and scarring in the
post-operative period. As a result, it promises to substantially improve long-term outcomes for
sinus surgery and, as my research has demonstrated, reduced scarring and inflammation
correlates with absence of the need for further surgery. I believe the combination of minimally
invasive techniques and local drug delivery will be the wave of the future in sinus treatment.”
In October 2011, David C. Brodner, M.D. continued his commitment to providing his patients the latest cutting-edge technology and became the first Sinus Surgeon in Florida to use the Propel Implant. He has since placed hundreds of the implants and noticed a significant improvement in his Sinus patients' outcomes.
Dr. Brodner now travels around the country educating other Sinus Surgeons on the benefits of the Propel Implant and instructs them on proper technique and management.