Abstract
Background: Airway HyperResponsiveness (AHR) in asthma is correlated with decrease of functional parameters and exacerbations.Different phenotypic expression in asthma requires valid biomarkers to monitor the disease.
Aim: To assess the effect of the level of AHR on the preservation of asthmatic control.
Methods: 98 asthmatic pts with ACT (Asthma Control Test) >20, nonsmokers were enrolled in a 3yrs controlled randomized trial. Group A (49) (ICS) receiving a continuous treatment with inhaled beclomethasone MDI100mcg twice/die+salbutamol as needed, and Group B (49) (control) treated with inhaled salbutamol as needed. Step up therapy was performed as recommended by guidelines. Measures of PD20 (methacoline), ACT, exacerbations, use of drug, and visits are scheduled every 3 months. Primary endpoints were AHR, ACTscore, exacerbations, therapy as needed.
Results: Significant difference of mean PD20 (mcg) was reported between the 2 groups.
Although groupB showed values higher than groupA,no significant difference were reported for ACT (A20.1,B19.7), exacerbations/3mths (A3.9,B4.2), medical visits/3mths (A4.4,B4.7), puffs as needed/3mths (A16.8,B19.6), days high dosage ICS/3mths (A47.4,B48.8), days oral CS/3mths (A0.35,B0.39).
Conclusion: In controlled asthma long term treatment with low dosage ICS determine a significant reduction ofAHR. It may lead to a greater control of the disease and a less impairment of spirometric parameters over the years, even if the clinical impact is less significant.
- © 2011 ERS