FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 331:637-642 September 8, 1994 Number 10 Next

	Full Text Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Respiratory disease in patients with cystic fibrosis is characterized by airway obstruction caused by the accumulation of thick, purulent secretions, which results in recurrent, symptomatic exacerbations. The viscoelasticity of the secretions can be reduced in vitro by recombinant human deoxyribonuclease I (rhDNase), a bioengineered copy of the human enzyme.

Methods We performed a randomized, double-blind, placebo-controlled study to determine the effects of once-daily and twice-daily administration of rhDNase on exacerbations of respiratory symptoms requiring parenteral antibiotics and on pulmonary function. A total of 968 adults and children with cystic fibrosis were treated for 24 weeks as outpatients.

Results One or more exacerbations occurred in 27 percent of the patients given placebo, 22 percent of those treated with rhDNase once daily, and 19 percent of those treated with rhDNase twice daily. As compared with placebo, the administration of rhDNase once daily and twice daily reduced the age-adjusted risk of respiratory exacerbations by 28 percent (P = 0.04) and 37 percent (P<0.01), respectively. The administration of rhDNase once daily and twice daily improved forced expiratory volume in one second during the study by a mean (±SD) of 5.8 ±0.7 and 5.6 ±0.7 percent, respectively. None of the patients had anaphylaxis. Voice alteration and laryngitis were more frequent in the rhDNase-treated patients than in those receiving placebo but were rarely severe and resolved within 21 days of onset.

Conclusions In patients with cystic fibrosis, the administration of rhDNase reduced but did not eliminate exacerbations of respiratory symptoms, resulted in slight improvement in pulmonary function, and was well tolerated. .

Source Information

From the Department of Medical Affairs, Genentech, Inc., South San Francisco (H.J.F., D.H.C., M.L.N.); the Children's Hospital of Buffalo, Buffalo, N.Y. (D.S.B.); G.H. Besselaar Associates, Princeton, N.J. (E.M.M.); Children's Hospital and Medical Center of Seattle, Seattle (B.W.R., A.L.S.); Johns Hopkins University, Baltimore (B.J.R); the Pulmozyme Study Group, and Children's Hospital, Boston (M.E.W.). The members of the Pulmozyme Study Group and the participating institutions are listed in the Appendix.

Address reprint requests to Dr. Fuchs at Genentech, Inc., 460 Point San Bruno Blvd., South San Francisco, CA 94080.

Full Text of this Article

Related Letters:

Cost-Effectiveness Analyses
Steinberg E. P., Powe N. R., Schulman K., Simonich W. L., Tilson H., Kotsanos J. G., Flanagin A., Rennie D., Kassirer J. P., Angell M.
Extract | Full Text  
N Engl J Med 1995; 332:123-125, Jan 12, 1995. Correspondence

This article has been cited by other articles:

• Barbato, A., Frischer, T., Kuehni, C. E., Snijders, D., Azevedo, I., Baktai, G., Bartoloni, L., Eber, E., Escribano, A., Haarman, E., Hesselmar, B., Hogg, C., Jorissen, M., Lucas, J., Nielsen, K. G., O'Callaghan, C., Omran, H., Pohunek, P., Strippoli, M-P. F., Bush, A. (2009). Primary ciliary dyskinesia: a consensus statement on diagnostic and treatment approaches in children. Eur Respir J 34: 1264-1276 [Abstract] [Full Text]  
• Huffmyer, J. L., Littlewood, K. E., Nemergut, E. C. (2009). Perioperative Management of the Adult with Cystic Fibrosis. Anesth. Analg. 109: 1949-1961 [Abstract] [Full Text]  
• Bush, A. (2009). Treatment of Cystic Fibrosis: Time for a New Paradigm?. Chest 136: 1197-1199 [Full Text]  
• Foweraker, J. E., Laughton, C. R., Brown, D. F., Bilton, D. (2009). Comparison of Methods To Test Antibiotic Combinations against Heterogeneous Populations of Multiresistant Pseudomonas aeruginosa from Patients with Acute Infective Exacerbations in Cystic Fibrosis. Antimicrob. Agents Chemother. 53: 4809-4815 [Abstract] [Full Text]  
• Hubert, D., Le Roux, E., Lavrut, T., Wallaert, B., Scheid, P., Manach, D., Grenet, D., Sermet-Gaudelus, I., Ramel, S., Cracowski, C., Sardet, A., Wizla, N., Deneuville, E., Garraffo, R. (2009). Continuous versus Intermittent Infusions of Ceftazidime for Treating Exacerbation of Cystic Fibrosis. Antimicrob. Agents Chemother. 53: 3650-3656 [Abstract] [Full Text]  
• Bush, A., Hogg, C. (2009). Many a slip?. Eur Respir J 34: 293-294 [Full Text]  
• Retsch-Bogart, G. Z., Quittner, A. L., Gibson, R. L., Oermann, C. M., McCoy, K. S., Montgomery, A. B., Cooper, P. J. (2009). Efficacy and Safety of Inhaled Aztreonam Lysine for Airway Pseudomonas in Cystic Fibrosis. Chest 135: 1223-1232 [Abstract] [Full Text]  
• Abbott, J (2009). Health-related quality of life measurement in cystic fibrosis: advances and limitations. Chronic Respiratory Disease 6: 31-41 [Abstract]  
• Mall, M. A. (2009). Role of the amiloride-sensitive epithelial Na+ channel in the pathogenesis and as a therapeutic target for cystic fibrosis lung disease. Exp Physiol 94: 171-174 [Abstract] [Full Text]  
• Zhou, Z., Treis, D., Schubert, S. C., Harm, M., Schatterny, J., Hirtz, S., Duerr, J., Boucher, R. C., Mall, M. A. (2008). Preventive but Not Late Amiloride Therapy Reduces Morbidity and Mortality of Lung Disease in {beta}ENaC-overexpressing Mice. Am. J. Respir. Crit. Care Med. 178: 1245-1256 [Abstract] [Full Text]  
• Redding, G. J., Kishioka, C., Martinez, P., Rubin, B. K. (2008). Physical and Transport Properties of Sputum From Children With Idiopathic Bronchiectasis. Chest 134: 1129-1134 [Abstract] [Full Text]  
• Saavedra, M. T., Hughes, G. J., Sanders, L. A., Carr, M., Rodman, D. M., Coldren, C. D., Geraci, M. W., Sagel, S. D., Accurso, F. J., West, J., Nick, J. A. (2008). Circulating RNA Transcripts Identify Therapeutic Response in Cystic Fibrosis Lung Disease. Am. J. Respir. Crit. Care Med. 178: 929-938 [Abstract] [Full Text]  
• Rowe, S. M., Jackson, P. L., Liu, G., Hardison, M., Livraghi, A., Solomon, G. M., McQuaid, D. B., Noerager, B. D., Gaggar, A., Clancy, J. P., O'Neal, W., Sorscher, E. J., Abraham, E., Blalock, J. E. (2008). Potential Role of High-Mobility Group Box 1 in Cystic Fibrosis Airway Disease. Am. J. Respir. Crit. Care Med. 178: 822-831 [Abstract] [Full Text]  
• Goss, C. H (2008). Should we stop using intravenous gentamicin in patients with cystic fibrosis?. Thorax 63: 479-480 [Full Text]  
• Jarad, N. A., Giles, K. (2008). Risk factors for increased need for intravenous antibiotics for pulmonary exacerbations in adult patients with cystic fibrosis. Chronic Respiratory Disease 5: 29-33 [Abstract]  
• Boogaard, R, Smit, F, Schornagel, R, Vaessen-Verberne, A A P H, Kouwenberg, J M, Hekkelaan, M, Hendriks, T, Feith, S W W, Hop, W C J, de Jongste, J C, Merkus, P J F M (2008). Recombinant human deoxyribonuclease for the treatment of acute asthma in children. Thorax 63: 141-146 [Abstract] [Full Text]  
• Flume, P. A., O'Sullivan, B. P., Robinson, K. A., Goss, C. H., Mogayzel, P. J. Jr., Willey-Courand, D. B., Bujan, J., Finder, J., Lester, M., Quittell, L., Rosenblatt, R., Vender, R. L., Hazle, L., Sabadosa, K., Marshall, B. (2007). Cystic Fibrosis Pulmonary Guidelines: Chronic Medications for Maintenance of Lung Health. Am. J. Respir. Crit. Care Med. 176: 957-969 [Abstract] [Full Text]  
• Boyle, M. P. (2007). Adult Cystic Fibrosis. JAMA 298: 1787-1793 [Abstract] [Full Text]  
• van der Giessen, L. J., Gosselink, R., Hop, W. C. J., Tiddens, H. A. W. M. (2007). Recombinant human DNase nebulisation in children with cystic fibrosis: before bedtime or after waking up?. Eur Respir J 30: 763-768 [Abstract] [Full Text]  
• Ramsey, B. W. (2007). Use of Lung Imaging Studies as Outcome Measures for Development of New Therapies in Cystic Fibrosis. Proc Am Thorac Soc 4: 359-363 [Abstract] [Full Text]  
• Ramsey, B. W. (2007). Outcome Measures for Development of New Therapies in Cystic Fibrosis: Are We Making Progress and What Are the Next Steps?. Proc Am Thorac Soc 4: 367-369 [Full Text]  
• Mayer-Hamblett, N., Ramsey, B. W., Kronmal, R. A. (2007). Advancing Outcome Measures for the New Era of Drug Development in Cystic Fibrosis. Proc Am Thorac Soc 4: 370-377 [Abstract] [Full Text]  
• Goss, C. H., Quittner, A. L. (2007). Patient-reported Outcomes in Cystic Fibrosis. Proc Am Thorac Soc 4: 378-386 [Abstract] [Full Text]  
• Bell, S. C, Robinson, P. J (2007). Exacerbations in cystic fibrosis: 2 {middle dot} Prevention. Thorax 62: 723-732 [Abstract] [Full Text]  
• Tingpej, P., Smith, L., Rose, B., Zhu, H., Conibear, T., Al Nassafi, K., Manos, J., Elkins, M., Bye, P., Willcox, M., Bell, S., Wainwright, C., Harbour, C. (2007). Phenotypic Characterization of Clonal and Nonclonal Pseudomonas aeruginosa Strains Isolated from Lungs of Adults with Cystic Fibrosis. J. Clin. Microbiol. 45: 1697-1704 [Abstract] [Full Text]  
• Elborn, J S, Bell, S C (2007). Pulmonary exacerbations in cystic fibrosis and bronchiectasis. Thorax 62: 288-290 [Full Text]  
• Goss, C. H, Burns, J. L (2007). Exacerbations in cystic fibrosis {middle dot} 1: Epidemiology and pathogenesis. Thorax 62: 360-367 [Abstract] [Full Text]  
• Boogaard, R., Hulsmann, A. R., van Veen, L., Vaessen-Verberne, A. A. P. H., Yap, Y. N., Sprij, A. J., Brinkhorst, G., Sibbles, B., Hendriks, T., Feith, S. W. W., Lincke, C. R., Brandsma, A. E., Brand, P. L. P., Hop, W. C. J., de Hoog, M., Merkus, P. J. F. M. (2007). Recombinant Human Deoxyribonuclease in Infants With Respiratory Syncytial Virus Bronchiolitis. Chest 131: 788-795 [Abstract] [Full Text]  
• Enderby, B., Doull, I. (2007). Hypertonic saline inhalation in cystic fibrosis--salt in the wound, or sweet success?. Arch. Dis. Child. 92: 195-196 [Full Text]  
• Taylor, L. M, Kuhn, R. J (2007). Hypertonic Saline Treatment of Cystic Fibrosis. The Annals of Pharmacotherapy 41: 481-484 [Abstract] [Full Text]  
• Rubin, B. K., Kater, A. P., Goldstein, A. L. (2006). Thymosin {beta}4 Sequesters Actin in Cystic Fibrosis Sputum and Decreases Sputum Cohesivity in Vitro.. Chest 130: 1433-1440 [Abstract] [Full Text]  
• Sanders, N N, Franckx, H, De Boeck, K, Haustraete, J, De Smedt, S C, Demeester, J (2006). Role of magnesium in the failure of rhDNase therapy in patients with cystic fibrosis.. Thorax 61: 962-966 [Abstract] [Full Text]  
• Block, J K, Vandemheen, K L, Tullis, E, Fergusson, D, Doucette, S, Haase, D, Berthiaume, Y, Brown, N, Wilcox, P, Bye, P, Bell, S, Noseworthy, M, Pedder, L, Freitag, A, Paterson, N, Aaron, S D (2006). Predictors of pulmonary exacerbations in patients with cystic fibrosis infected with multi-resistant bacteria. Thorax 61: 969-974 [Abstract] [Full Text]  
• Shead, E. F., Haworth, C. S., Gunn, E., Bilton, D., Scott, M. A., Compston, J. E. (2006). Osteoclastogenesis during Infective Exacerbations in Patients with Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 174: 306-311 [Abstract] [Full Text]  
• Balfour-Lynn, I. M., Lees, B., Hall, P., Phillips, G., Khan, M., Flather, M., Elborn, J. S., on behalf of the CF WISE (Withdrawal of Inhaled St, (2006). Multicenter Randomized Controlled Trial of Withdrawal of Inhaled Corticosteroids in Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 173: 1356-1362 [Abstract] [Full Text]  
• Davis, P. B. (2006). Cystic Fibrosis Since 1938. Am. J. Respir. Crit. Care Med. 173: 475-482 [Abstract] [Full Text]  
• Serisier, D. J., Shute, J. K., Hockey, P. M., Higgins, B., Conway, J., Carroll, M. P. (2006). Inhaled heparin in cystic fibrosis. Eur Respir J 27: 354-358 [Abstract] [Full Text]  
• Elkins, M. R., Robinson, M., Rose, B. R., Harbour, C., Moriarty, C. P., Marks, G. B., Belousova, E. G., Xuan, W., Bye, P. T.P., the National Hypertonic Saline in Cystic Fibrosis, (2006). A Controlled Trial of Long-Term Inhaled Hypertonic Saline in Patients with Cystic Fibrosis. NEJM 354: 229-240 [Abstract] [Full Text]  
• Ratjen, F. (2006). Restoring Airway Surface Liquid in Cystic Fibrosis. NEJM 354: 291-293 [Full Text]  
• Goss, C. H., Rubenfeld, G. D., Ramsey, B. W., Aitken, M. L. (2006). Clinical Trial Participants Compared with Nonparticipants in Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 173: 98-104 [Abstract] [Full Text]  
• de Jong, P A, Lindblad, A, Rubin, L, Hop, W C J, de Jongste, J C, Brink, M, Tiddens, H A W M (2006). Progression of lung disease on computed tomography and pulmonary function tests in children and adults with cystic fibrosis. Thorax 61: 80-85 [Abstract] [Full Text]  
• Cimmino, M., Nardone, M., Cavaliere, M., Plantulli, A., Sepe, A., Esposito, V., Mazzarella, G., Raia, V. (2005). Dornase Alfa as Postoperative Therapy in Cystic Fibrosis Sinonasal Disease. Arch Otolaryngol Head Neck Surg 131: 1097-1101 [Abstract] [Full Text]  
• Tang, J. X., Wen, Q., Bennett, A., Kim, B., Sheils, C. A., Bucki, R., Janmey, P. A. (2005). Anionic poly(amino acid)s dissolve F-actin and DNA bundles, enhance DNase activity, and reduce the viscosity of cystic fibrosis sputum. Am. J. Physiol. Lung Cell. Mol. Physiol. 289: L599-L605 [Abstract] [Full Text]  
• Fitzgerald, D. A., Hilton, J., Jepson, B., Smith, L. (2005). A Crossover, Randomized, Controlled Trial of Dornase Alfa Before Versus After Physiotherapy in Cystic Fibrosis. Pediatrics 116: e549-e554 [Abstract] [Full Text]  
• Smyth, R. L (2005). Diagnosis and management of cystic fibrosis. EDUCATION AND PRACTICE 90: ep1-ep6 [Full Text]  
• Aurora, P, Gustafsson, P, Bush, A, Lindblad, A, Oliver, C, Wallis, C E, Stocks, J (2004). Multiple breath inert gas washout as a measure of ventilation distribution in children with cystic fibrosis. Thorax 59: 1068-1073 [Abstract] [Full Text]  
• Carpagnano, G. E., Barnes, P. J., Francis, J., Wilson, N., Bush, A., Kharitonov, S. A. (2004). Breath Condensate pH in Children With Cystic Fibrosis and Asthma: A New Noninvasive Marker of Airway Inflammation?. Chest 125: 2005-2010 [Abstract] [Full Text]  
• Brody, A. S. (2004). Scoring Systems for CT in Cystic Fibrosis: Who Cares?. Radiology 231: 296-298 [Full Text]  
• Rancourt, R. C., Tai, S., King, M., Heltshe, S. L., Penvari, C., Accurso, F. J., White, C. W. (2004). Thioredoxin liquefies and decreases the viscoelasticity of cystic fibrosis sputum. Am. J. Physiol. Lung Cell. Mol. Physiol. 286: L931-L938 [Abstract] [Full Text]  
• Paul, K., Rietschel, E., Ballmann, M., Griese, M., Worlitzsch, D., Shute, J., Chen, C., Schink, T., Doring, G., van Koningsbruggen, S., Wahn, U., Ratjen, F. (2004). Effect of Treatment with Dornase Alpha on Airway Inflammation in Patients with Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 169: 719-725 [Abstract] [Full Text]  
• Ordonez, C. L., Henig, N. R., Mayer-Hamblett, N., Accurso, F. J., Burns, J. L., Chmiel, J. F., Daines, C. L., Gibson, R. L., McNamara, S., Retsch-Bogart, G. Z., Zeitlin, P. L., Aitken, M. L. (2003). Inflammatory and Microbiologic Markers in Induced Sputum after Intravenous Antibiotics in Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 168: 1471-1475 [Abstract] [Full Text]  
• Modi, A. C., Quittner, A. L. (2003). Validation of a Disease-Specific Measure of Health-Related Quality of Life for Children with Cystic Fibrosis. J Pediatr Psychol 28: 535-546 [Abstract] [Full Text]  
• Gibson, R. L., Burns, J. L., Ramsey, B. W. (2003). Pathophysiology and Management of Pulmonary Infections in Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 168: 918-951 [Abstract] [Full Text]  
• Saiman, L., Marshall, B. C., Mayer-Hamblett, N., Burns, J. L., Quittner, A. L., Cibene, D. A., Coquillette, S., Fieberg, A. Y., Accurso, F. J., Campbell, P. W. III (2003). Azithromycin in Patients With Cystic Fibrosis Chronically Infected With Pseudomonas aeruginosa: A Randomized Controlled Trial. JAMA 290: 1749-1756 [Abstract] [Full Text]  
• Robinson, T. E., Leung, A. N., Northway, W. H., Blankenberg, F. G., Chan, F. P., Bloch, D. A., Holmes, T. H., Moss, R. B. (2003). Composite Spirometric-Computed Tomography Outcome Measure in Early Cystic Fibrosis Lung Disease. Am. J. Respir. Crit. Care Med. 168: 588-593 [Abstract] [Full Text]  
• Weiner, D. J., Bucki, R., Janmey, P. A. (2003). The Antimicrobial Activity of the Cathelicidin LL37 Is Inhibited by F-actin Bundles and Restored by Gelsolin. Am. J. Respir. Cell Mol. Bio. 28: 738-745 [Abstract] [Full Text]  
• Thomas, S R (2003). The pulmonary physician in critical care * Illustrative case 1: Cystic fibrosis. Thorax 58: 357-360 [Abstract] [Full Text]  
• Johnson, C., Butler, S. M., Konstan, M. W., Morgan, W., Wohl, M. E. B. (2003). Factors Influencing Outcomes in Cystic Fibrosis: A Center-Based Analysis. Chest 123: 20-27 [Abstract] [Full Text]  
• Robertson, C F (2002). How do we choose a therapeutic regimen in cystic fibrosis?. Thorax 57: 839-840 [Full Text]  
• Suri, R, Grieve, R, Normand, C, Metcalfe, C, Thompson, S, Wallis, C, Bush, A (2002). Effects of hypertonic saline, alternate day and daily rhDNase on healthcare use, costs and outcomes in children with cystic fibrosis. Thorax 57: 841-846 [Abstract] [Full Text]  
• Suri, R., Marshall, L. J., Wallis, C., Metcalfe, C., Bush, A., Shute, J. K. (2002). Effects of Recombinant Human DNase and Hypertonic Saline on Airway Inflammation in Children with Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 166: 352-355 [Abstract] [Full Text]  
• Merkus, P.J.F.M., Tiddens, H.A.W.M., de Jongste, J.C. (2002). Annual lung function changes in young patients with chronic lung disease. Eur Respir J 19: 886-891 [Abstract] [Full Text]  
• Lyczak, J. B., Cannon, C. L., Pier, G. B. (2002). Lung Infections Associated with Cystic Fibrosis. Clin. Microbiol. Rev. 15: 194-222 [Abstract] [Full Text]  
• Cook, R J, Lawless, J F (2002). Analysis of repeated events. Stat Methods Med Res 11: 141-166 [Abstract]  
• Britto, M. T., Kotagal, U. R., Hornung, R. W., Atherton, H. D., Tsevat, J., Wilmott, R. W. (2002). Impact of Recent Pulmonary Exacerbations on Quality of Life in Patients With Cystic Fibrosis. Chest 121: 64-72 [Abstract] [Full Text]  
• Milross, M. A., Piper, A. J., Norman, M., Willson, G. N., Grunstein, R. R., Sullivan, C. E., Bye, P. T. P. (2001). Predicting Sleep-Disordered Breathing in Patients With Cystic Fibrosis. Chest 120: 1239-1245 [Abstract] [Full Text]  
• LiPuma, J. J. (2001). Microbiological and Immunologic Considerations With Aerosolized Drug Delivery. Chest 120 : 118S-123S [Abstract] [Full Text]  
• Hassan, N. O. E., Chess, P. R., Huysman, M. W. A., Merkus, P. J. F. M., de Jongste, J. C. (2001). Rescue Use of DNase in Critical Lung Atelectasis and Mucus Retention in Premature Neonates. Pediatrics 108: 468-470 [Abstract] [Full Text]  
• Nasr, S. Z., Strouse, P. J., Soskolne, E., Maxvold, N. J., Garver, K. A., Rubin, B. K., Moler, F. W. (2001). Efficacy of Recombinant Human Deoxyribonuclease I in the Hospital Management of Respiratory Syncytial Virus Bronchiolitis. Chest 120: 203-208 [Abstract] [Full Text]  
• Robinson, C. A., Kuhn, R. J. (2001). Management of Pulmonary Disease in Patients with Cystic Fibrosis. Journal of Pharmacy Practice 14: 207-227 [Abstract]  
• Liou, T. G., Adler, F. R., FitzSimmons, S. C., Cahill, B. C., Hibbs, J. R., Marshall, B. C. (2001). Predictive 5-Year Survivorship Model of Cystic Fibrosis. Am J Epidemiol 153: 345-352 [Abstract] [Full Text]  
• SOOD, N., PARADOWSKI, L. J., YANKASKAS, J. R. (2001). Outcomes of Intensive Care Unit Care in Adults with Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 163: 335-338 [Abstract] [Full Text]  
• MILROSS, M. A., PIPER, A. J., NORMAN, M., BECKER, H. F., WILLSON, G. N., GRUNSTEIN, R. R., SULLIVAN, C. E., BYE, P. T. P. (2001). Low-flow Oxygen and Bilevel Ventilatory Support . Effects on Ventilation during Sleep in Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 163: 129-134 [Abstract] [Full Text]  
• Quittner, A. L., Sweeny, S., Watrous, M., Munzenberger, P., Bearss, K., Nitza, A. G., Fisher, L. A., Henry, B. (2000). Translation and Linguistic Validation of a Disease-Specific Quality of Life Measure for Cystic Fibrosis. J Pediatr Psychol 25: 403-414 [Abstract] [Full Text]  
• Raynor, E. M., Butler, A., Guill, M., Bent III, J. P. (2000). Nasally Inhaled Dornase Alfa in the Postoperative Management of Chronic Sinusitis Due to Cystic Fibrosis. Arch Otolaryngol Head Neck Surg 126: 581-583 [Abstract] [Full Text]  
• Fung, E. B., Barden, E. M., Wasserman, D., Zemel, B. S., Heinrich, B. T., Scanlin, T. F., Stallings, V. A. (1999). A Six-Month Study of Growth and Energy Expenditure in Children with Cystic Fibrosis Taking a Pulmonary Inhalation Medication (rhDNase). J. Am. Coll. Nutr. 18: 330-338 [Abstract] [Full Text]  
• Dwyer, M. A., Huang, A. J., Pan, C. Q., Lazarus, R. A. (1999). Expression and Characterization of a DNase I-Fc Fusion Enzyme. J. Biol. Chem. 274: 9738-9743 [Abstract] [Full Text]  
• Ramsey, B. W., Pepe, M. S., Quan, J. M., Otto, K. L., Montgomery, A. B., Williams-Warren, J., Vasiljev-K, M., Borowitz, D., Bowman, C. M., Marshall, B. C., Marshall, S., Smith, A. L., The Cystic Fibrosis Inhaled Tobramycin Study Group, (1999). Intermittent Administration of Inhaled Tobramycin in Patients with Cystic Fibrosis. NEJM 340: 23-30 [Abstract] [Full Text]  
• Davis, J C Jr, Manzi, S, Yarboro, C, Rairie, J, Mcinnes, I, Averthelyi, D, Sinicropi, D, Hale, V G, Balow, J, Austin, H, Boumpas, D T, Klippel, J H (1999). Recombinant human Dnase I (rhDNase) in patients with lupus nephritis. Lupus 8: 68-76 [Abstract]  
• RATJEN, F., TUMMLER, B. (1999). Domiciliary NIPPV in COPD.. Thorax 54: 91-91 [Full Text]  
• INNES, J A. (1998). DNase in cystic fibrosis: the challenge of assessing response and maximising benefit. Thorax 53: 1003-1004 [Full Text]  
• Milla, C. E (1998). Long term effects of aerosolised rhDNase on pulmonary disease progression in patients with cystic fibrosis. Thorax 53: 1014-1017 [Abstract] [Full Text]  
• Pan, C. Q., Dodge, T. H., Baker, D. L., Prince, W. S., Sinicropi, D. V., Lazarus, R. A. (1998). Improved Potency of Hyperactive and Actin-resistant Human DNase I Variants for Treatment of Cystic Fibrosis and Systemic Lupus Erythematosus. J. Biol. Chem. 273: 18374-18381 [Abstract] [Full Text]  
• Pan, C. Q., Lazarus, R. A. (1998). Hyperactivity of Human DNase I Variants. DEPENDENCE ON THE NUMBER OF POSITIVELY CHARGED RESIDUES AND CONCENTRATION, LENGTH, AND ENVIRONMENT OF DNA. J. Biol. Chem. 273: 11701-11708 [Abstract] [Full Text]  
• FENG, W., GARRETT, H., SPEERT, D. P., KING, M. (1998). Improved Clearability of Cystic Fibrosis Sputum with Dextran Treatment in vitro. Am. J. Respir. Crit. Care Med. 157: 710-714 [Abstract] [Full Text]  
• Grasemann, H, Ioannidis, I, Tomkiewicz, R P, de Groot, H, Rubin, B K, Ratjen, F (1998). Nitric oxide metabolites in cystic fibrosis lung disease. Arch. Dis. Child. 78: 49-53 [Abstract] [Full Text]  
• Greenberger, P. A. (1997). Immunologic Aspects of Lung Diseases and Cystic Fibrosis. JAMA 278: 1924-1930 [Abstract]  
• Anzueto, A., Jubran, A., Ohar, J. A., Piquette, C. A., Rennard, S. I., Colice, G., Pattishall, E. N., Barrett, J., Engle, M., Perret, K. A., Rubin, B. K. (1997). Effects of Aerosolized Surfactant in Patients With Stable Chronic Bronchitis: A Prospective Randomized Controlled Trial. JAMA 278: 1426-1431 [Abstract]  
• DIOT, P., PALMER, L. B., SMALDONE, A., DECELIE-GERMANA, J., GRIMSON, R., SMALDONE, G. C. (1997). RhDNase I Aerosol Deposition and Related Factors in Cystic Fibrosis. Am. J. Respir. Crit. Care Med. 156: 1662-1668 [Abstract] [Full Text]  
• KING, M., DASGUPTA, B., TOMKIEWICZ, R. P., BROWN, N. E. (1997). Rheology of Cystic Fibrosis Sputum after in vitro Treatment with Hypertonic Saline Alone and in Combination with Recombinant Human Deoxyribonuclease I. Am. J. Respir. Crit. Care Med. 156: 173-177 [Abstract] [Full Text]  
• CONWAY, S. P (1997). Recombinant human DNase (rhDNase) in cystic fibrosis: is it cost effective?. Arch. Dis. Child. 77: 1-3 [Full Text]  
• CANTIN, A. M. (1997). DNase I Acutely Increases Cystic Fibrosis Sputum Elastase Activity and its Potential to Induce Lung Hemorrhage in Mice. Am. J. Respir. Crit. Care Med. 157: 464-469 [Abstract] [Full Text]  
• Rous, E, Coppel, A, Haworth, J, Noyce, S (1996). A purchaser experience of managing new expensive drugs: interferon beta. BMJ 313: 1195-1196 [Full Text]  
• Ramsey, B. W. (1996). Management of Pulmonary Disease in Patients with Cystic Fibrosis. NEJM 335: 179-188 [Full Text]  
• Tran, J. H., Brennan, K. M. (1996). Management of the Child With Cystic Fibrosis. Journal of Pharmacy Practice 9: 75-90 [Abstract]  
• Robert, G., Stevens, A., Colin-Jones, D. (1995). Dornase alfa for cystic fibrosis. BMJ 311: 813-813 [Full Text]  
• du Bois, R M (1995). Recent Advances: Respiratory medicine. BMJ 310: 1594-1597 [Full Text]  
• Henry, D., Hill, S. (1995). Comparing treatments. BMJ 310: 1279-1279 [Full Text]