A comparative study of hypertonic saline, daily and alternate-day rhDNase in children with cystic fibrosis

Suri R, Wallis C, Bush A, Thompson S, Normand C, Flather M, Grieve R, Metcalfe C, Lees B
Record ID 32003000016
Authors' objectives:

The objective of this study was to compare the efficacy and cost-effectiveness of daily recombinant human deoxyribonuclease (rhDNase), alternate-day rhDNase and hypertonic saline (HS) in the treatment of children with cystic fibrosis (CF).

Authors' results and conclusions: A total of 48 children were recruited to the study. Following 12 weeks of treatment, there was a mean increase in FEV1 over baseline of 16% (standard deviation (SD) 25%), 14% (SD 22%) and 3% (SD 21%) with daily rhDNase, alternate-day rhDNase and HS, respectively. Comparing daily rhDNase with alternate-day rhDNase, there was no evidence of difference between the treatments (2%; 95% confidence interval (CI), 4% to +9%; p=0.55). However, daily rhDNase showed a significantly greater increase in FEV1 compared with HS (8%; 95% CI, 2% to 14%; p=0.01).
Authors' recommendations: Alternate-day rhDNase appears to be as effective as daily rhDNase in CF and, on average, reduces health service costs. It appears that 7% HS is not as effective as daily rhDNase, although there was some variation in individual response. To support these results, a follow-up long-term parallel trial comparing daily rhDNase with alternate-day rhDNase, which includes a health economic analysis, should be performed.
Authors' methods: Randomised crossover trial
Project Status: Completed
URL for project: http://www.hta.ac.uk/1037
Year Published: 2002
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Costs and Cost Analysis
  • Saline Solution, Hypertonic
  • Cystic Fibrosis
  • Deoxyribonuclease I
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
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