TY - JOUR T1 - Inhaled corticosteroids in patients with mild to moderate COPD with and without airway hyperresponsiveness to mannitol: A randomized placebo controlled trial JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p3361 AU - Andreas Scherr AU - Jochmann Anja AU - Schaffroth Salome AU - David Miedinger AU - Maier Sabrina AU - Anne Taegtmeyer AU - Chajed Prashant AU - Sandra Anderson AU - Tamm Michael AU - Jörg Daniel Leuppi Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p3361.abstract N2 - Background: Based on former data airway hyperresponsiveness (AHR) to mannitol challenge could allow to identify a subgroup of subjects who will respond to treatment with ICS.Methods: We investigated 68 subjects with mild to moderately severe COPD. All subjects were treated with tiotropium initiated 4 weeks prior to randomisation. Subjects were randomized to either budesonide (daily dose of 1600 mcg) or placebo for 3 months. At all visits lung function, quality of Life (SGRQ), AHR to mannitol, exhaled nitric oxide (NO) and MRC were assessed. AHR was defined as a 15% fall in FEV1 at < or = 635 mg (PD15). RDR was calculated as the percent fall in FEV1 at the last dose divided by totally dose of mannitol administered.Results: There was no significant change from baseline of FEV1% pred. (2.46 95% CI [-1; 5.9] p= 0.162), quality of life (SGRQ) (-3.21 95% CI [-8.5; 2.1] p= 0.227), nitric oxide (-5.48 95% CI [-11.2; 0.2] p=0.058) and MRC (0.4 95% CI [0.1; 1.7] p= 0.22) after budesonid treatment. AHR to mannitol was present in 56% of subjects. Steroid treated subjects with AHR showed a significant improvement in quality of life (SGRQ) (8.64 95% CI [1.17; 16.11] p= 0.024), which was not observed in absence of AHR. Concomitantly AHR responded to steroid treatment showing a significant decline in log10 RDR as compared to placebo (0.27 95% CI [-0.04; 0.58] p= 0.09). Our findings were independent from smoking status.Conclusion: AHR to mannitol improves and seems to result in a better quality of life after ICS treatment in mild to moderate COPD. ER -