RT Journal Article
SR Electronic
T1 Improved effects of formoterol-budesonide combination on residual eosinophilic inflammation in asthmatic peripheral airway
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4123
VO 42
IS Suppl 57
A1 Hiroyuki Ohbayashi
A1 Mitsuru Adachi
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4123.abstract
AB Aims: To evaluate the inhibitory effect of formoterol-budesonide combination (FBC) on residual eosinophilic inflammation in the peripheral airways of well-controlled asthmatic patients compared with salmeterol-fluticasone propionate combination (SFC). Methods: Forty one outpatients (57.5+/-19.9yrs) with well-controlled moderate asthma who had used SFC for more than 3 months were the subjects. Evidence of eosinophilic cationic protein (ECP) and surfactant protein D (SP-D) in 10% hypertonic saline-induced sputum was assessed, together with pulmonary function testing, impulse oscillometry system (IOS), exhaled nitric oxide (FeNO), and the Asthma-related Quality of Life Questionnaire (AQLQ). Results: Eosinophilic inflammation was detected in the peripheral airway of 17 patients (41.5%) and they were switched to FBC. As higher levels of sputum SP-D were obtained from the nearer peripheral airway area, significantly higher ECP levels in late-phase sputum may indicate residual asthmatic inflammation in the peripheral airway. The ECP levels in late-phase sputum, 218.1+/-256.6ug/1 at study entry, significantly decreased to 49.4+/- 42.3 (p=0.031) and 48.1+/- 45.3 (p=0.035) at 4 and 8 weeks, respectively, after switching to treatment with the FBC. The FeNo levels (61.2+/-59.7 ppb at study entry) also significantly decreased 26.7+/-16.8(p=0.023) at 8 weeks. The R5-R20 and AX values of IOS parameters and both symptom and emotional function domains of the AQLQ also significantly improved after 8 weeks. Conclusion: This suggests that the FBC may give better control of residual eosinophilic inflammation in the peripheral airway compared to SFC therapy.