RT Journal Article
SR Electronic
T1 Study design supporting the effectiveness of inhaled extra-fine beclomethasone/formoterol at the level of small airways of asthmatics
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4116
VO 42
IS Suppl 57
A1 Todor Popov
A1 Daniela Petrova
A1 Tanya Kralimarkova
A1 Yavor Ivanov
A1 Tsanya Popova
A1 Tsvetanka Odzhahova
A1 Yanislava Ilieva
A1 Plamen Yakovliev
A1 Tsvetelina Lazarova
A1 Ognyan Georgiev
A1 Marinka Peneva
A1 Vladimir Hodzhev
A1 Elena Hodzheva
A1 Maria Staevska
A1 Vasil Dimitrov
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4116.abstract
AB Background. We made an attempt to establish in what way does treatment with inhaled extra-fine beclomethasone/formoterol (I-EF-BDP/F) formulation differ from other combined preparations of ICS and long acting beta-agonist (LABA).Methods. This was real life clinical observation of asthmatics switched to I-EF-BDP/F (Foster, Chiesi Pharma, Italy) from dry powder inhalers of fluticasone/salmetrol and budesonide/formoterol. Effects of 8-weeks treatment were documented by spirometry and airway / systemic inflammation: exhaled breath temperature (EBT), blood eosinophils (Eos) and C-reactive protein (CRP).Results. 59 patients completed the study (mean age 51 ± SD 12 years, 38 women). They did not show significant pre/post changes in the inflammatory indices (EBT, Eos and CRP). However, when we ranked them according to the pre/post treatment differences in forced vital capacity % predicted (FVC, a simple indicator of small airways involvement), the subjects above the 75th percentile (“top responders”, n=15), demonstrated significant drop in EBT [ºC] (34.04±0.30 vs. 33.57±0.33, P=0.003) and Eos [cells/μL] (381.7±91.2 vs. 244.2±43.2, P=0.018). The pre/post EBT and CRP differences of the “top responders” significantly exceeded those of the patients below the 25th percentile of FVC: P=0.04 and 0.05 respectively.Conclusion. Subjects demonstrating highest improvement in FVC after transition to I-EF-BDP/F from other combined ICS/LABA preparations had prominent decrease in the level of inflammation. As FVC is a simple indicator of small airway involvement, these results support the notion that I-EF-BDP/F may exert its effects in the small airway.