A six week double blind, placebo controlled, crossover study of the effect of misoprostol in the treatment of aspirin sensitive asthma
Wojciech Wasiak, Miros
aw Szmidt
IInd Department of
Tuberculosis and Lung Diseases, Institute of Tuberculosis and Lung
Disease in Warsaw, 181 Okólna Str., 91-520 
ód
, Poland
Correspondence to: Dr M Szmidt.
Received 28 September 1998; Returned to authors 11 February 1999; Revised version received 2 June 1999; Accepted for publication 23 June 1999
BACKGROUND
Prostaglandins
of the E series and misoprostol (a stable analogue of prostaglandin
E1) prevent bronchoconstriction following aspirin ingestion
or inhalation in subjects with aspirin sensitive asthma. A study was
undertaken to investigate the influence of misoprostol on the course of
aspirin induced asthma.
METHODSA double
blind, crossover, randomised, placebo controlled study was performed in
17 patients with aspirin sensitive asthma (13 women) aged 26-68 years.
All subjects had aspirin sensitivity confirmed by means of oral aspirin
or inhaled lysine aspirin challenge. Misoprostol (Cytotec, Searle,
800 or 1600 µg daily according to individual tolerance) or placebo
were administered over a period of six weeks. Morning and evening peak
expiratory flow rate (PEFR), 
2 agonist use, asthma and
rhinitis severity scores, and defaecation score were measured daily. At
the beginning and end of each treatment period spirometric tests were
performed and blood was taken for eosinophil count. Eight subjects took
misoprostol at a dose of 800 µg and nine subjects at a dose of
1600 µg daily.
RESULTSNo differences
were seen in asthma control between misoprostol and placebo except for
the rhinorrhoea score which was lower on misoprostol during the period
of the study.
CONCLUSIONMisoprostol
in a daily dose of 800 or 1600 µg does not significantly improve
asthma control in subjects with aspirin sensitive asthma.
Keywords: aspirin sensitive asthma; prostaglandin E1; misoprostol
© 1999 by Thorax
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