The New England journal of medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) results from a progressive decline in lung function, which is thought to be the consequence of airway inflammation. We hypothesized that antiinflammatory therapy with inhaled corticosteroids would slow this decline. ⋯ Inhaled triamcinolone does not slow the rate of decline in lung function in people with COPD, but it improves airway reactivity and respiratory symptoms and decreases the use of health care services for respiratory problems. These benefits should be weighed against the potential long-term adverse effects of triamcinolone on bone mineral density.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Fludarabine compared with chlorambucil as primary therapy for chronic lymphocytic leukemia.
Fludarabine is an effective treatment for chronic lymphocytic leukemia that does not respond to initial treatment with chlorambucil. We compared the efficacy of fludarabine with that of chlorambucil in the primary treatment of chronic lymphocytic leukemia. ⋯ When used as the initial treatment for chronic lymphocytic leukemia, fludarabine yields higher response rates and a longer duration of remission and progression-free survival than chlorambucil.