Initial improvements in lung function and bronchial hyperresponsiveness are maintained during 5 years of treatment with inhaled beclomethasone dipropionate and terbutaline
| Autor: | Huib A. M. Kerstjens, Dirkje S. Postma, Gerard H. Koeïter, Shelley E. Overbeek, Ad de Gooijer, W. Rob Douma |
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| Přispěvatelé: | Groningen Research Institute for Asthma and COPD (GRIAC), Pulmonary Medicine |
| Rok vydání: | 2002 |
| Předmět: |
Budesonide
Male DEPENDENT ASTHMATICS Critical Care and Intensive Care Medicine Pulmonary function testing RESPONSIVENESS AIR-FLOW OBSTRUCTION Bronchodilator Anti-Asthmatic Agents BRONCHODILATOR THERAPY MILD ASTHMA education.field_of_study LONG-TERM TREATMENT Beclomethasone respiratory system Middle Aged Treatment Outcome Bronchial hyperresponsiveness Anesthesia AIRWAYS DISEASE Drug Therapy Combination Female Bronchial Hyperreactivity Cardiology and Cardiovascular Medicine Lung Volume Measurements medicine.drug circulatory and respiratory physiology Pulmonary and Respiratory Medicine Adult long-term study medicine.drug_class Population Terbutaline BUDESONIDE Administration Inhalation medicine Humans education Asthma Dose-Response Relationship Drug business.industry Beclometasone dipropionate obstructive airways disease medicine.disease Long-Term Care respiratory tract diseases CLINICAL ASTHMA inhaled corticosteroids business FOLLOW-UP Follow-Up Studies |
| Zdroj: | Chest, 121(1), 151-157. ELSEVIER SCIENCE BV Chest, 121(1), 151-157. American College of Chest Physicians |
| ISSN: | 0012-3692 |
| Popis: | Objectives Treatment with inhaled corticosteroids reduces bronchial hyperresponsiveness and relieves airways obstruction in patients with asthma. Up to now, it is unknown whether initial improvements are maintained over a long period of time. Therefore, we assessed whether initial improvements in FEV 1 , provocative concentration of histamine causing a 20% fall in FEV 1 (PC 20 ), and peak expiratory flow (PEF) persist with a constant dose of inhaled corticosteroids. Furthermore, we investigated whether FEV 1 , PC 20 , PEF indexes, and symptom scores improve after increasing the dose of inhaled corticosteroids in patients who did not respond sufficiently to treatment with beclomethasone dipropionate (BDP), 800 μg/d. Methods Sixty-eight patients with bronchial hyperresponsiveness and airways obstruction completed a previous study on 3 years of treatment with terbutaline, 500 μg qid, and BDP, 200 μg qid. Fifty-eight of these patients participated in the current extension of another 2.5 years of follow-up. Every 6 months, FEV 1 and PC 20 were measured. Five patients dropped out of the study, one for pulmonary reasons. Forty-four patients continued treatment with BDP, 800 μg/d (BDP-800 group), and 9 patients received a higher dose of BDP (500 μg tid; BDP-1,500 group) after the first 3 years because of a rapid decline in FEV 1 (> 50 mL/yr) despite BDP treatment during the previous study period. Results After the initial improvement, the mean slope of individual regression lines for FEV 1 , PC 20 , and morning PEF were − 28 mL/yr,− 0.01 doubling concentrations per year, and 0.6 L/min/yr, respectively, in the BDP-800 group. In the BDP-1,500 group, there were no statistically significant improvements in FEV 1 , PC 20 , PEF indexes, and symptom scores after increasing the dose of BDP. Conclusions We conclude that initial improvements in FEV 1 , PC 20 , and PEF are well preserved over 5 years in patients with obstructive airways diseases who are treated with terbutaline and BDP. In the patients who responded sufficiently to 800 μg/d of BDP, there was no accelerated decline in FEV 1 compared with the general population. Increasing the dose of BDP in a small group of patients with an accelerated fall in FEV 1 (initially treated with a moderate dose of BDP) resulted in no significant improvement in FEV 1 , PC 20 , PEF indexes, and symptom scores. |
| Databáze: | OpenAIRE |
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