K. Mccoy et al., EFFECTS OF 12-WEEK ADMINISTRATION OF DORNASE ALFA IN PATIENTS WITH ADVANCED CYSTIC-FIBROSIS LUNG-DISEASE, Chest, 110(4), 1996, pp. 889-895
Study objective: The 12-week efficacy and safety of aerosolized recomb
inant human DNase (dornase alfa) were evaluated in previously untreate
d patients with cystic fibrosis (CF) with advanced lung disease. Desig
n: In this multicenter, double-blind, placebo-controlled study, CF pat
ients with advanced lung disease were randomized to receive either dor
nase alfa or placebo once a day for 12 weeks. Patients: A total of 320
patients in clinically stable condition with documented CF and an FVC
less than 40% of predicted were recruited from 65 CF Foundation care
centers in the United States. The dornase alfa and placebo groups were
comparable with respect to age (range, 7 to 57 years), height, and we
ight, Male subjects outnumbered female subjects (55% vs 45%) and few s
ubjects were younger than 17 years of age (15%), The percentages of pr
edicted FEV(1) and FVC were significantly lower in the dornase alfa gr
oup at baseline (p less than or equal to 0.05). Interventions: Patient
s were randomly assigned to receive either 2.5 mg dornase alfa once da
ily (n=158) or placebo once daily (n=162). All patients continued to r
eceive standard medications and treatments administered for CF. Measur
ements and results: Dornase alfa improved the mean percent change in F
EV(1) from baseline by 9.4% compared with 2.1% for placebo (p<0.001).
The actively treated group showed a 12.4% improvement in FVC compared
with 7.3% for placebo (p<0.01). There were no differences between the
treatment groups in dyspnea score, number of days receiving IV antibio
tics, or length of hospital stay; the overall incidence of adverse eve
nts was comparable between treatment groups, Fifteen patients died: 9
in the dornase alfa group and 6 in the placebo group; no differentiati
ng clinical characteristics were demonstrated. Conclusions: Pulmonary
function as measured by FEV(1) and FVC improved significantly in the d
ornase alfa-treated patients, Dornase alfa was found to be safe and we
ll tolerated over the 12-week study period.