Chest
Clinical InvestigationsASTHMABronchodilator Response to Albuterol After Regular Formoterol and Effects of Acute Corticosteroid Administration
Section snippets
Patients
Twelve patients with stable, moderate to severe persistent asthma (7 women and 5 men; mean ± SD age, 43 ± 15 years; all taking inhaled corticosteroids) were recruited to take part in a randomized, placebo-controlled, double-blind, crossover study (Table 1). All were using inhaled short-actingβ 2-agonists (less than two puffs per day) for symptomatic relief purposes. Two subjects were taking inhaled salmeterol and one subject was taking inhaled formoterol twice daily. Three subjects were also
Results
Thirteen subjects were recruited in total; 1 subject dropped out because of an exacerbation of asthma during the third formoterol limb (the last limb of the trial) caused by a chest infection. The data for this patient were excluded from the analysis, and one more subject was randomized to completion. All of these 12 subjects completed the study, and no other adverse events were reported. Treatment with formoterol produced significant improvements in morning (p = 0.004) and evening (p = 0.0004)
Discussion
Our results showed that regular twice-daily formoterol produced subsensitivity of the bronchodilator response to repeated puffs of albuterol for effects on both FEV1 and FEF25–75% response (as AUC). We found that an approximately eightfold higher dose of albuterol would be required to elicit the same increase in FEV1 after formoterol compared to placebo. The present study only looked at airwayβ 2-adrenoceptor responses, although we have previously reported subsensitivity of systemicβ 2
ACKNOWLEDGMENTS
The authors thank Dr. I. P. Hall, Department of Therapeutics, University Hospital, Nottingham, UK, for performing the genotype analysis.
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This study was sponsored by a research grant from Astra Draco AB (Sweden).