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The effect of inhaled corticosteroids on the maximal degree of airway narrowing to methacholine in asthmatic subjects.
Am Rev Respir Dis. 1991 Jan; 143(1):109-13.AR

Abstract

Airway hyperresponsiveness in asthma is characterized by an increase in sensitivity and in maximal response to airway-narrowing stimuli. Long-term therapy with inhaled corticosteroids is known to reduce airway hypersensitivity in asthmatic patients. To investigate whether these drugs also reduce the maximal degree of airway narrowing we studied the effects of inhaled budesonide on the maximal response plateau of the dose-response curve to inhaled methacholine in mildly asthmatic patients in whom a raised plateau could be measured. Sixteen atopic patients with mild asthma were placed randomly into two parallel treatment groups to receive double-blindly either budesonide (400 micrograms twice daily) or placebo, inhaled via a Turbuhaler, for 4 wk. Before treatment, after 2 and 4 wk of treatment, and after 2 and 4 wk of wash-out, complete dose-response curves to methacholine were obtained using a standardized 2-min tidal breathing method. The response was measured by FEV1, expressed in % fall from baseline. A plateau on the log dose-response curve was considered if three or more data points fell within a 5% response range. The maximal response was obtained by averaging the values on the plateau (MFEV1), and the sensitivity was calculated from the provocative concentration of methacholine, causing a 20% fall in FEV1 (PC20). After 4 wk of budesonide treatment, mean MFEV1 decreased from 41.6 to 33.7% fall (p = 0.0004). The changes in MFEV1 were significantly different between placebo and budesonide (p = 0.03). The geometric mean PC20 increased from 3.4 to 6.3 mg/ml (p = 0.02), but the changes in PC20 were not different between the two groups (p = 0.23).(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Department of Pulmonology, University Hospital, Leiden, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

1986667

Citation

Bel, E H., et al. "The Effect of Inhaled Corticosteroids On the Maximal Degree of Airway Narrowing to Methacholine in Asthmatic Subjects." The American Review of Respiratory Disease, vol. 143, no. 1, 1991, pp. 109-13.
Bel EH, Timmers MC, Zwinderman AH, et al. The effect of inhaled corticosteroids on the maximal degree of airway narrowing to methacholine in asthmatic subjects. Am Rev Respir Dis. 1991;143(1):109-13.
Bel, E. H., Timmers, M. C., Zwinderman, A. H., Dijkman, J. H., & Sterk, P. J. (1991). The effect of inhaled corticosteroids on the maximal degree of airway narrowing to methacholine in asthmatic subjects. The American Review of Respiratory Disease, 143(1), 109-13.
Bel EH, et al. The Effect of Inhaled Corticosteroids On the Maximal Degree of Airway Narrowing to Methacholine in Asthmatic Subjects. Am Rev Respir Dis. 1991;143(1):109-13. PubMed PMID: 1986667.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of inhaled corticosteroids on the maximal degree of airway narrowing to methacholine in asthmatic subjects. AU - Bel,E H, AU - Timmers,M C, AU - Zwinderman,A H, AU - Dijkman,J H, AU - Sterk,P J, PY - 1991/1/1/pubmed PY - 1991/1/1/medline PY - 1991/1/1/entrez SP - 109 EP - 13 JF - The American review of respiratory disease JO - Am. Rev. Respir. Dis. VL - 143 IS - 1 N2 - Airway hyperresponsiveness in asthma is characterized by an increase in sensitivity and in maximal response to airway-narrowing stimuli. Long-term therapy with inhaled corticosteroids is known to reduce airway hypersensitivity in asthmatic patients. To investigate whether these drugs also reduce the maximal degree of airway narrowing we studied the effects of inhaled budesonide on the maximal response plateau of the dose-response curve to inhaled methacholine in mildly asthmatic patients in whom a raised plateau could be measured. Sixteen atopic patients with mild asthma were placed randomly into two parallel treatment groups to receive double-blindly either budesonide (400 micrograms twice daily) or placebo, inhaled via a Turbuhaler, for 4 wk. Before treatment, after 2 and 4 wk of treatment, and after 2 and 4 wk of wash-out, complete dose-response curves to methacholine were obtained using a standardized 2-min tidal breathing method. The response was measured by FEV1, expressed in % fall from baseline. A plateau on the log dose-response curve was considered if three or more data points fell within a 5% response range. The maximal response was obtained by averaging the values on the plateau (MFEV1), and the sensitivity was calculated from the provocative concentration of methacholine, causing a 20% fall in FEV1 (PC20). After 4 wk of budesonide treatment, mean MFEV1 decreased from 41.6 to 33.7% fall (p = 0.0004). The changes in MFEV1 were significantly different between placebo and budesonide (p = 0.03). The geometric mean PC20 increased from 3.4 to 6.3 mg/ml (p = 0.02), but the changes in PC20 were not different between the two groups (p = 0.23).(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0003-0805 UR - https://www.unboundmedicine.com/medline/citation/1986667/The_effect_of_inhaled_corticosteroids_on_the_maximal_degree_of_airway_narrowing_to_methacholine_in_asthmatic_subjects_ L2 - http://www.atsjournals.org/doi/full/10.1164/ajrccm/143.1.109?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -