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Recombinant human DNase in children with airway malacia and lower respiratory tract infection
Author(s) -
Boogaard Ruben,
de Jongste Johan C.,
VaessenVerberne Anja A.P.H.,
Hop Wim C.J.,
Merkus Peter J.F.M.
Publication year - 2009
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.21073
Subject(s) - malacia , medicine , placebo , airway , respiratory tract infections , anesthesia , lower respiratory tract infection , sputum , respiratory tract , respiratory system , pathology , tuberculosis , alternative medicine
Background Children with airway malacia often have protracted courses of airway infections, because dynamic airway collapse during coughing results in impaired mucociliary clearance. The aim of this study was to determine the effect of the mucolytic drug recombinant human deoxyribonuclease (rhDNase) on the recovery of respiratory symptoms in children with airway malacia and lower respiratory tract infection (LRTI). Methods In a randomized double‐blind controlled clinical trial, 40 children with airway malacia and LRTI were randomly assigned to receive either 2.5 mg nebulized rhDNase or placebo twice daily for 2 weeks. The primary endpoint was the change in the cough diary score (CDS) (scale 0–5) from baseline to the second week of treatment. Secondary endpoints were VAS symptom scores for cough, dyspnea, and difficulty in expectorating sputum, need for an antibiotic course, and lung function data (FVC, FEV 1 , FEF 75 , R int e). Results There was no significant difference in the mean change in CDSs from baseline between the rhDNase group and the placebo group (mean difference for daytime 0.19 (95% CI −0.53 to 0.90); for nighttime 0.38 (95% CI −0.30 to 1.05). Proportions of patients requiring antibiotics, and the mean changes in symptom scores and lung function from baseline did not significantly differ between both groups. Conclusion Treatment with 2 weeks of nebulized rhDNase does not enhance recovery or reduce the need for antibiotics in children with airway malacia and LRTI. (Controlled‐trials.com number, ISRCTN85366144). Pediatr Pulmonol. 2009; 44:962–969. ©2009 Wiley‐Liss, Inc.