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Is a longer time interval between recombinant human deoxyribonuclease (Dornase Alfa) and chest physiotherapy better?: A multi-center, randomized crossover trial

Wilson, C., Robbins, L., Murphy, J. and Chang, Anne B. (2007). Is a longer time interval between recombinant human deoxyribonuclease (Dornase Alfa) and chest physiotherapy better?: A multi-center, randomized crossover trial. Pediatric Pulmonology,42(12):1110-1116.

Document type: Journal Article
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IRMA ID 10003xPUB2
Title Is a longer time interval between recombinant human deoxyribonuclease (Dornase Alfa) and chest physiotherapy better?: A multi-center, randomized crossover trial
Author Wilson, C.
Robbins, L.
Murphy, J.
Chang, Anne B.
Journal Name Pediatric Pulmonology
Publication Date 2007
Volume Number 42
Issue Number 12
ISSN 1099-0496   (check CDU catalogue open catalogue search in new window)
Start Page 1110
End Page 1116
Total Pages 7
Place of Publication New York
Publisher John Wiley & Sons, Inc.
Field of Research 1114 - Paediatrics and Reproductive Medicine
HERDC Category C1 - Journal Article (DEST)
Abstract Background: Although the benefits of recombinant human deoxyribonuclease (dornase alfa) in patients with cystic fibrosis (CF) are established, its optimal timing in relation to physiotherapy is unknown. As its enzymatic effect lasts for 6-11 hr, dornase alfa may be more efficacious if the time interval between inhalation and chest physiotherapy is increased. The aim of this study was to investigate if a longer time interval between dornase alfa nebulization and chest physiotherapy improves clinical outcomes of subjects with CR Methods: A single-blind randomized cross-over trial was conducted on subjects with CF from outpatients of four hospitals. Subjects were in stable health and studied over 6 weeks (utilizing 14-day blocks of morning or evening dornase alfa administration with 14 days washout). Usual regimens for physiotherapy and exercise were unaltered. Thus changing the times altered the dwell time of dornase alfa prior to physiotherapy. Long interval was defined as dwell time of >6 hr and short as ≤6 hr. Outcomes were measured at pre and post each regimen. Results: Twenty subjects aged 7-40 years completed the study. At end of long interval regimen, (median interval =11.1 hr), FEF25-75% and CF-specific quality of life significantly improved compared to baseline values and to short interval regimen (median interval = 0.25 hr) outcomes. FVC, FEV1, sputum weights, and adherence were similar in both regimens. Conclusions: A longer time interval between dornase alfa and physiotherapy is more efficacious than short interval. Administration timing of dornase alfa based on patient choice to incorporate longer interval time is likely to be the best regimen for patients previously established on dornase alfa nebulization.
DOI http://dx.doi.org/10.1002/ppul.20704   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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