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Unaltered perception of dyspnoea during treatment with long-acting ß₂-agonists

Dept of Pulmonology, Martini Hospital, Groningen, the Netherlands

CORRESPONDENCE: R. Aalbers, Dept of Pulmonology, Martini Hospital, Postbus 30033, 9700 RM, Groningen, the Netherlands. Fax: 31 505245937

Keywords: Borg, dyspnoea, formoterol, perception, salmeterol

Received: September 28, 2000
Accepted April 4, 2001

This work was supported by a research grant from AstraZeneca, the Netherlands.

There is the possibility that during treatment with inhaled long-acting ß₂-agonists that a loss of perception of dyspnoea might occur and that the forced expiratory volume in one second (FEV₁) might fall precipitously during bronchial provocation. This study investigated these possibilities during methacholine provocation, continued until there was 30% fall in FEV₁, mimicking a moderate asthma attack.

Nineteen asthmatic patients were asked to score their dyspnoea as a Borg score during provocation with methacholine. One hour prior to this provocation, the patients used the last morning dose of 14 days treatment with either formoterol (twice daily 24 µg by Turbuhaler®), salmeterol (twice daily 100 µg by Diskhaler^TM) and placebo in a double-blind, randomized, double-dummy, cross-over design.

The perception of dyspnoea, expressed as the Borg score divided by the change in FEV₁ at 30% fall in FEV₁, was similar on the three test days at 0.067, 0.076 and 0.074%^–1 after formoterol, salmeterol and placebo treatment, respectively (p=0.16). The slope of the methacholine dose response curve did not differ (p=0.52).

In conclusion, no suggestion was found for an abnormal perception of dyspnoea or an exaggerated fall in forced expiratory volume in one second during provocation with methacholine under long-acting ß₂-agonist treatment.

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