Extrafine compared to non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma - 24/08/17
, Ilse M. Boudewijn a, b, 1 , Sebastiaan J. Vroegop c , Siebrig Schokker c , Anne J. Lexmond d , Henderik W. Frijlink d , Paul Hagedoorn d , Judith M. Vonk b, e , Martijn P. Farenhorst a , Nick H.T. Ten Hacken a, b , Huib A.M. Kerstjens a, b , Dirkje S. Postma a, b , Maarten van den Berge a, b Abstract |
Background |
Smoking is as prevalent in asthmatics as in the general population. Asthmatic smokers benefit less from inhaled corticosteroids (ICS) than non-smoking asthmatics, possibly due to more smoking-induced small airways disease. Thus targeting small airways may be important in treating asthmatic (ex-)smokers. We hypothesized that extrafine particle ICS improve small airways function more than non-extrafine particle ICS in asthmatic (ex-)smokers.
Methods |
We performed an open-label, randomized, three-way cross-over study comparing extrafine beclomethasone (HFA-QVAR) to non-extrafine beclomethasone (HFA-Clenil) and fluticasone (HFA-Flixotide) in 22 smokers and 21 ex-smokers with asthma (≥5 packyears).
Results |
Improvement from baseline in PD20 adenosine after using QVAR, Clenil or Flixotide was 1.04 ± 1.71, 1.09 ± 2.12 and 0.94 ± 1.97 doubling doses, mean ± standard deviation (SD), respectively. The change from baseline in R5-R20 at PD20 adenosine after using QVAR, Clenil or Flixotide was −0.02 ± 0.27, 0.02 ± 0.21, and −0.02 ± 0.31 kPa sL−1, mean ± SD, respectively. The change in PD20 adenosine and R5-R20 at PD20 adenosine were neither statistically significant different between QVAR and Clenil (p = 0.86 and p = 0.82) nor between QVAR and Flixotide (p = 0.50 and p = 0.96).
Conclusion |
Similar effectiveness in improving small airways function was found for extrafine and non-extrafine particle ICS treatment for asthmatic smokers and ex-smokers.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Extrafine and non-extrafine particle inhalation corticosteroids were compared. |
• | Smokers and ex-smokers with asthma were included. |
• | QVAR, Clenil and Flixotide were compared with adenosine provocation and IOS. |
• | ΔPD20 adenosine and ΔR5-R20 at PD20 adenosine is comparable for the treatments. |
• | Extrafine and non-extrafine particle ICS equally improve small airways function. |
Keywords : AMP, Dry powder adenosine, ICS, Provocation, Small airways
Plan
Vol 130
P. 35-42 - septembre 2017 Retour au numéro
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