Document Detail

Effect of ciclesonide dose and duration of therapy on exercise-induced bronchoconstriction in patients with asthma.
MedLine Citation:
PMID:  16675326     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Inhaled corticosteroid therapy improves exercise symptoms in asthmatic subjects.
OBJECTIVE: We sought to evaluate exercise-induced bronchoconstriction (EIB) as a method of determining the dose and time responses of inhaled corticosteroid therapy.
METHODS: In this double-blind, randomized, cross-over study with 2 parallel arms, 4 doses of inhaled ciclesonide (40 microg and 160 microg or 80 microg and 320 microg) were compared over 3 weeks of treatment. Twenty-six asthmatic subjects (age range, 14-27 years) with baseline FEV1 values of greater than 70% of predicted value were enrolled. The primary outcome was the maximum percentage decrease in FEV1 after standardized exercise challenge.
RESULTS: After 1 week of therapy, the mean +/- SEM reduction in maximum decrease in FEV1 in the ciclesonide 40-microg/80-microg dose group was 9% +/- 2.6% (95% CI, 3.9% to 14%), with no additional reduction thereafter. In the ciclesonide 160-microg/320-microg dose group, there was an 8.7% +/- 2.5% (95% CI, 3.7% to 13.7%) reduction in maximum decrease in FEV1 after week 1, which continued in a linear fashion during subsequent weeks of treatment. No difference was found between the 2 treatment arms in the temporal response of EIB to ciclesonide treatment. The maximum percentage attenuation in EIB achieved was 51.1% +/- 7.9%, which was achieved by using the 320-microg dose after 3 weeks of treatment.
CONCLUSIONS: A significant improvement in EIB was demonstrated for all doses of ciclesonide. Use of 160 microg/320 microg of ciclesonide resulted in a continuing improvement in FEV1 with time, and no plateau was seen in protective effect during 3 weeks of treatment.
CLINICAL IMPLICATIONS: Attenuation in exercise-induced decrease can be seen as early as after 1 week of therapy with inhaled ciclesonide at doses greater than 40 microg. However, maximal attenuation in exercise response continues to increase at doses greater than or equal to 200 microg, even after 3 weeks of therapy.
Padmaja Subbarao; Mylinh Duong; Ellinor Adelroth; Joceline Otis; George Obminski; Mark Inman; Soren Pedersen; Paul M O'byrne
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  117     ISSN:  0091-6749     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-05     Completed Date:  2006-06-07     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1008-13     Citation Subset:  AIM; IM    
Hospital for Sick Children, University of Toronto, Ontario, Canada.
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MeSH Terms
Administration, Inhalation
Asthma, Exercise-Induced / drug therapy*,  physiopathology
Bronchoconstriction / drug effects*
Bronchodilator Agents / administration & dosage*
Cross-Over Studies
Dose-Response Relationship, Drug
Double-Blind Method
Pregnenediones / pharmacology*
Time Factors
Reg. No./Substance:
0/Bronchodilator Agents; 0/Pregnenediones; S59502J185/ciclesonide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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