TY - JOUR T1 - Fluticasone propionate inhaled 3 hours after an early allergic reaction partially inhibits the late phase reaction JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p1782 AU - Bart Jacobs AU - Gail Gauvreau AU - Rick Watson AU - Abbey Torek AU - Karen Howie AU - Kieran Killian AU - Paul O'Byrne Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p1782.abstract N2 - Introduction: Inhalation of 800μg budesonide (AJRCCM 1994;149:1447) or 500μg beclomethasone (JACI 1993;91:1163) upon resolution of the allergen-induced early phase response inhibits the late phase asthmatic response (LAR) by 39% and 70%, respectively. This has never been tested for the highly lipophilic corticosteroid fluticasone propionate (FP).Methods: This randomized double-blinded, placebo-controlled, 3-way crossover study (NCT00716963) was conducted in 6, mild allergic asthmatic patients with a documented dual bronchoconstrictor responses to inhaled allergen. Patients underwent 3 allergen challenges separated by 14 day washout periods. Patients inhaled placebo, 250μg or 1000μg FP at 3 h after allergen challenge, and the magnitude of the LAR was measured at regular intervals until 7 h post challenge. Sputum induction was performed before, 7 h and 24 h post challenge, and methacholine PC20 measured before and 24 h post challenge.Results: Five patients completed the study. 250μg and 1000μg FP significantly attenuated the LAR compared to placebo; the mean (SD) maximum% fall in FEV1 during the late response was 25.2% (6.2) with placebo, 15.1% (7.1) with 250μg FP (p=0.01), and 18.3% (8.2) with 1000μg FP (p=0.04). Inhibition of the LAR was 40% and 27% for 250μg and 1000μg FP, respectively. There was no effect of FP on allergen-induced sputum eosinophils, with a trend for reduced AHR which was not statistically significant.Conclusions: FP given three hours after allergen challenge attenuates the LAR, demonstrating that this lipophilic corticosteroid reduces the LAR when administered after allergen exposure.This research was conducted with support from AstraZeneca. ER -