RT Journal Article
SR Electronic
T1 Functional effects of long term ICS treatment in controlled asthma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p895
VO 38
IS Suppl 55
A1 Angelo Petroianni
A1 Vittoria Conti
A1 Eirini Lemontzi
A1 Irina Mininni
A1 Francesca Oriolo
A1 Viviana D'Alù
A1 Luciana Locorriere
A1 Claudio Terzano
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p895.abstract
AB Background: Goal of asthma management is the “control” of the disease,monitoring symptoms and FEV1orPEF. However, in controlled asthma the persistence of a long term asymptomatic airway inflammation may lead to an accelerated functional decline.Aim: To estimate the protective effect of a long term treatment with low dosage of ICS on functional parameters in controlled asthmaMethods: 98 asthmatic pts with ACT (Asthma Control Test) >20, nonsmokers were enrolled in a 3 yrs controlled randomized trial. Patients were divided in 2 groups: group A (49) (ICS) receiving a continuous treatment with inhaled beclomethasone MDI100mcg twice/die +inhaled salbutamol as needed; group B (49) (control) treated with inhaled salbutamol as needed. Step up therapy was performed as recommended by guidelines. Every 3 months, measures of FEV1, FVC, MEF, RV, TLC, FRC, ACT, PD20 (methacoline) were performed. Primary endpoint were: variation of functional parameters, PD20, and ACTscoreResults: Δ was the difference between time 0 and at 3yrs. Significant difference was reported for RV/TLC: A 30.9±3.2 (Δ+0.5), B 33.7±3.3 (Δ+2.5); PD20 (mcg): A 1232.5±301 (Δ+699), B 656.74±280 (Δ+55); FEV1/FVC at the attainment of PD20: A 64.2%±2.9 (Δ+0.4), B 67.6%±3.0 (Δ+4.9). No significant differences reported for FEV1 (A 3.94, B 3.86), FVC (A 5.27, B 5.15), FEV1/FVC (A 74.7%, B 74,9%), MEF25% (A 1.30, B 1.09), ACTscore (A 20.1, B 19.7), side effects (A 8, B 9).Conclusion: A long term treatment with low dosage of ICS and the reduction of airway responsiveness are bound to a better preservation of the respiratory function in controlled asthma. It is probably due to a better control of a slight air trapping and asymptomatic involvement of small airways, as suggested by the greater decrease of FVC at PD20 in non treated group.