Efficacy and safety of TOBI Podhaler in Pseudomonas aeruginosa-infected bronchiectasis patients: iBEST study.
Eur Respir J
; 57(1)2021 01.
Article
en En
| MEDLINE
| ID: mdl-32855225
ABSTRACT
The study aimed to determine the efficacy of a safe and well-tolerated dose and regimen of tobramycin inhalation powder (TIP) on Pseudomonas aeruginosa sputum density in patients with bronchiectasis.This is a phase II, double-blind, randomised study in bronchiectasis patients aged ≥18â
years with chronic P. aeruginosa infection. Patients were randomised 111 to either cohort A three capsules of TIP once daily (84â
mg); cohort B five capsules once daily (140â
mg) or cohort C four capsules twice daily (224â
mg). Within each cohort, patients were further randomised 221 either to TIP continuously, TIP cyclically (alternating 28â
days of TIP and placebo) or placebo for 16â
weeks, respectively and were followed up for 8â
weeks.Overall, 107 patients were randomised to cohorts A (n=34), B (n=36) and C (n=37). All three TIP doses significantly reduced the P. aeruginosa sputum density from baseline to day 29 versus placebo in a dose-dependent manner (p≤0.0001, each). A smaller proportion of patients in the continuous-TIP (34.1%) and cyclical-TIP (35.7%) groups experienced pulmonary exacerbations versus placebo (47.6%) and also required fewer anti-pseudomonal antibiotics (38.6% on continuous TIP and 42.9% on cyclical TIP) versus placebo (57.1%) although not statistically significant. Pulmonary exacerbation of bronchiectasis was the most frequent (37.4%) adverse event. Overall, TIP was well tolerated, however, 23.4% of the patients discontinued the study drug due to adverse events.Continuous- and cyclical-TIP regimens with all three doses were safe and effective in reducing the P. aeruginosa sputum density in patients with bronchiectasis and chronic P. aeruginosa infection.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Infecciones por Pseudomonas
/
Bronquiectasia
Tipo de estudio:
Clinical_trials
Límite:
Adolescent
/
Adult
/
Humans
Idioma:
En
Revista:
Eur Respir J
Año:
2021
Tipo del documento:
Article
País de afiliación:
Reino Unido