Is normal bronchial responsiveness in asthmatics a reliable index for withdrawing inhaled corticosteroid treatment?

Chest
A MarabiniA Siracusa

Abstract

Inhaled corticosteroid (ICS) treatment is first-line maintenance therapy in bronchial asthma. However, it is not clear whether and when ICS treatment can be withdrawn. The aim of this open study was to assess whether normalization of bronchial responsiveness could be used as a reliable index to assess the opportunity of ICS treatment withdrawal. Open study at two different points in time. Outpatient pulmonary clinic. Eighteen asthmatic subjects. ICS therapy was withdrawn in subjects treated with beclomethasone dipropionate, at the maintenance dose of 889+/-246 microg/d for >3 months. Upon recruitment, all subjects were asymptomatic, had FEV1 >70% of predicted value, and were in treatment with beta2-agonists on an as-needed basis. Eight subjects (group 1) had normal bronchial responsiveness (methacholine provocative dose causing a 20% fall in FEV1 [PD20] >2,000 microg) and 10 subjects (group 2) had bronchial hyperresponsiveness (BHR) (PD20 < or = 2,000 microg). After withdrawal of ICS treatment, subjects were followed up for 3 weeks and were asked to record their asthma symptoms (cough, dyspnea, and wheezing) and their beta2-agonist use. At recruitment and at the end of follow-up, subjects underwent spirometry and a methacholine...Continue Reading

Citations

Nov 19, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Shawn D AaronUNKNOWN Canadian Respiratory Clinical Research Consortium
Oct 26, 1999·Chest·R L WolfL Coover
Feb 11, 2014·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Kaharu SuminoUNKNOWN Writing Committee for American Lung Association Asthma Clinical Research Centers
May 1, 2010·Respiratory Medicine·Helen K ReddelChristine R Jenkins
Nov 19, 2005·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Maria Teresa Mohallem FonsecaMarina Mohallem Fonseca
Jul 1, 2007·The Clinical Respiratory Journal·John D BrannanSandra D Anderson

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