Irreversible acinar airway abnormality in well controlled asthma.

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

RATIONALE:

Even in stable asthma patients, acinar ventilation distribution can be abnormal, and we aimed to specifically maximize its reversibility by switching patients from a standard inhaled corticosteroid (iCS) to a fine particle iCS formulation.

METHODS:

For this prospective double-blind double-dummy randomized study, 66 stable asthma patients under maintenance iCS (equivalent budesonide ? 800 ?g/day) were screened for abnormal baseline acinar ventilation heterogeneity (Sacin). After a 3-week run-in period, 35 eligible patients were randomized to fine particle beclomethasone (HFA-BDP; Qvar Autohaler) or to budesonide (DPI-BUD; Pulmicort Turbohaler). Asthma Control Test (ACT) score and various lung function indices reflecting the small airways were obtained at baseline, after 6 and 12 weeks.

RESULTS:

Thirty one patients [age:52 ± 17(SD) years; FEV1:76 ± 19(SD)%pred] completed the study (DPI-BUD:n = 16; HFA-BDP:n = 15). After 6 and 12 weeks, there were no significant changes in acinar or conductive ventilation heterogeneity, nor in mid-expiratory flow, RV/TLC, closing capacity, impulse oscillometry indices (resistance, reactance), bronchial NO production or alveolar NO, in either treatment arm. Asthma control was maintained in both arms.

CONCLUSION:

In stable asthma patients with small airways dysfunction under maintenance therapy, there is a residual functional abnormality in the lung periphery which is probably not eosinophilic in origin and cannot be normalized with the iCS formulations under study.
Original languageEnglish
Pages (from-to)1601-1607
Number of pages7
JournalRespiratory Medicine
Volume108
Issue number11
DOIs
Publication statusPublished - 2014

Keywords

  • Asthma
  • Fine particle inhaled steroids
  • Small airway function

Fingerprint Dive into the research topics of 'Irreversible acinar airway abnormality in well controlled asthma.'. Together they form a unique fingerprint.

Cite this