Treatment with inhaled steroids in patients with symptoms suggestive of asthma but with normal lung function

¹ Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
² Integrated Therapeutics Group, a subsidiary of Schering-Plough Corporation, Kenilworth, NJ, USA
³ Semeco AB, Ängelholm, Sweden

^* To whom correspondence should be addressed. E-mail: tari.haahtela{at}hus.fi.

	Abstract

A total of 144 patients with lower airway symptoms suggestive of asthma, but not fulfilling the functional criteria of asthma were included in a randomized, double-blind, placebo-controlled 8-week "proof-of-concept" study with mometasone furoate (MF), 400 µg once daily. The primary efficacy variable was the change from baseline in six mean morning (AM) and evening (PM) weekly symptom scores – cough, sputum production, wheeze, shortness of breath, chest tightness, and exercise-induced cough/wheeze. Total symptom scores were calculated after treatment for 4 and 8 weeks.

Compared with placebo MF improved total AM symptom score at 8 weeks. Changes in total PM symptom scores did not differ between treatments. MF improved all individual symptom scores more than placebo although the differences in changes between treatments was not always statistically sig-nificant. Morning and evening peak expiratory flow rates increased with MF compared with placebo. MF reduced eosinophils and the levels of eosinophilic cationic protein in induced sputum.

The results show that symptoms suggestive of asthma exist in patients without significant 2-agonist reversibility or diurnal variability in peak flow. Once-daily MF may benefit some of these patients and a short course with inhaled corticosteroids may be tried. Responders should be identified better in further studies.