Editorial
DNase in cystic fibrosis: the challenge of assessing response and maximising benefit
| The first 150 words of the full text of this article appear below. |
Since nebulised recombinant human DNase was licensed for
use in cystic fibrosis patients in March 1994, controversy has
continued over how this relatively expensive drug should be used to
maximum benefit. By cleaving DNA released from dead inflammatory cells it is dramatically effective in reducing sputum viscoelasticity in
vitro.1 In vivo, phase 2 trials showed encouraging
improvements in spirometric2 3 and other inflammatory
indices,4 and the major phase 3 trial used to support
licensing5 showed that once daily treatment gave a
relatively modest (5.8%) improvement in forced expiratory volume in
one second (FEV1) at 24 weeks, with a significant (after
age adjustment of the groups) reduction in exacerbations requiring
parenteral antibiotics. This large randomised trial (968 patients) was
notable, not only for the significance of the mean results, but also
for the wide variability of individual responses to treatment. For
example, 30% of actively treated patients showed an increase in
FEV1 of over 10%, but
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This article has been cited by other articles:
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TYRRELL, J C, LEWIS, P A, SHELDON, C D, CONNETT, G
(1999). rhDNase in cystic fibrosis. Thorax
54: 750f-750
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