Chest
Clinical InvestigationsAsthmaInitial Improvements in Lung Function and Bronchial Hyperresponsiveness Are Maintained During 5 Years of Treatment With Inhaled Beclomethasone Dipropionate and Terbutaline
Section snippets
Materials and Methods
The present study (hereafter called the second phase) was a 2.5-year continuation of a previous 3-year evaluation (hereafter called the first phase) of different treatment regimens (β2-agonist alone or in combination with an inhaled corticosteroid or an anticholinergic agent) in patients with bronchial hyperresponsiveness and moderate-to-severe airways obstruction (asthma and COPD).27 Two hundred seventy-four patients aged 18 to 60 years were originally included at six university pulmonary
Results
Fifty-eight of 68 patients were willing to participate in the second phase. These participants were 9.7 years older than the 10 nonparticipants (p < 0.05). There were no further statistically significant differences between these groups, especially not with respect to lung function or bronchial hyperresponsiveness. During the second phase, four subjects dropped out for other than pulmonary reasons. One additional patient receiving BDP, 800 μg/d, had frequent exacerbations and was switched to
Discussion
The second phase of this study was an observational one. With the current knowledge on efficacy of these anti-inflammatory drugs, it is not ethical to withhold patients from treatment with inhaled corticosteroids for years on end. The study shows that in patients with bronchial hyperresponsiveness and airways obstruction who respond to treatment with inhaled BDP and terbutaline, initial improvements in FEV1 percent predicted and PC20 were well maintained over an additional period of 5 years. An
Appendix
The Dutch Chronic Nonspecific Lung Disease Study Group consists of a steering committee (K.F. Kerrebijn, Ph.H. Quanjer, H.J. Sluiter), and members from the Departments of Pulmonology of the University Hospital of Amsterdam (E.M. Pouw, D.F.M.E. Schoonbrood, C.M. Roos, H.M. Jansen), Groningen (P.L.P. Brand, A. de Gooijer, H.A.M. Kerstjens, D.S. Postma, Th.W. van der Mark, H.J. Sluiter, G.H. Koeïter), Leiden (P.M. de Jong, P.J. Sterk, A.M.J. Wever, J.H. Dijkman), Nijmegen (P.N.R. Dekhuijzen,
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Cited by (8)
International Primary Care Respiratory Group (IPCRG) Guidelines: Management of asthma
2006, Primary Care Respiratory JournalSmall airways in asthma: Their independent contribution to the severity of hyperresponsiveness
2013, European Respiratory JournalThe importance of small airways in asthma
2013, MedicusInhaled corticosteroids and long-acting beta-agonists in adult asthma: A winning combination in all?
2008, Naunyn-Schmiedeberg's Archives of PharmacologyIndirect bronchial hyper-responsiveness: The coming of age of a specific group of bronchial challenges
2005, Clinical and Experimental Allergy
This study was made possible by grants from the Netherlands' Health Research Promotion Program and Glaxo. Medication was supplied by Astra Pharmaceuticals, Boehringer Ingelheim, and Glaxo.
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A complete list of participants is given in the Appendix.