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Copyright ©ERS Journals Ltd 2002
Assessment and evaluation of symptomatic steroid-naive asthmatics without sputum eosinophilia and their response to inhaled corticosteroids
1 Dept of Chest Medicine, Hôpital du Sacré-Coeur, Montreal and 2 Heart and Chest Institute, Hôpital Laval, Sainte Foy, Quebec, Canada
CORRESPONDENCE: C. Lemière, Dept of Chest Medicine, Sacré-Coeur Hospital, 5400 West Gouin, Montreal, Quebec, Canada, H4J 1C5. Fax: 1 5143383123. E-mail: lemierec@crhsc.umontreal.ca
Keywords: asthma, eosinophils, induced sputum, inhaled corticosteroids
Received: March 1, 2002
Accepted June 20, 2002
This study was funded by Réseau en santé respiratoire du FRSQ and GlaxoSmithKline Canada. C. Lemière and J-L. Malo are scholars of the Fonds de la recherche en santé du Québec.
Eosinophilic airway inflammation is one of the hallmarks of asthma. Sputum eosinophilia has been suggested as a predictor of the response to inhaled corticosteroids in asthma. This study sought to investigate the proportion of steroid-naive uncontrolled asthmatics without significant sputum eosinophilia (
A total of 51 mild uncontrolled steroid-naive asthmatics who had not been treated with oral or inhaled corticosteroids for at least 3 months were investigated. The evaluation included a spirometry, methacholine inhalation challenge and sputum induction on two occasions, one at baseline and the other after 1 month of treatment with 250 µg twice-daily fluticasone propionate.
Of the 51 subjects, 15 had an eosinophil count
The absence of sputum eosinophilia does not seem to be an indicator of poor response to inhaled corticosteroid treatment in steroid-naive asthmatics. However, this finding needs to be investigated further in a double-blind, placebo-controlled study, entirely designed to answer this question.
1%) and to examine whether sputum eosinophilia could predict the response to inhaled corticosteroids. 1%, and 46 completed the two visits. Patients with baseline sputum eosinophils 1% (n=14) were compared with those with sputum eosinophils >1% (n=32). The baseline characteristics of these two groups were similar. After 1 month of treatment, respiratory symptoms, quality of life, forced expiratory volume in one second (FEV1) and provocative concentration causing a 20% fall in FEV1 improved in both groups.
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