Document Detail

Effects of fluticasone propionate in COPD patients with bronchial hyperresponsiveness.
MedLine Citation:
PMID:  12149529     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Treatment of chronic obstructive pulmonary disease (COPD) with inhaled corticosteroids does not appear to be as effective as similar treatment of asthma. It seems that only certain subgroups of patients with COPD benefit from steroid treatment. A study was undertaken to examine whether inhaled fluticasone propionate (FP) had an effect on lung function and on indices of inflammation in a subgroup of COPD patients with bronchial hyperresponsiveness (BHR). METHODS: Twenty three patients with COPD were studied. Patients had to be persistent current smokers between 40 and 70 years of age. Non-specific BHR was defined as a PC(20) for histamine of <or=8 mg/ml. Patients received either 2 x 500 microg FP or placebo for 6 months. Expiratory volumes were measured at monthly visits, BHR was determined at the start of the study and after 3 and 6 months, and bronchial biopsy specimens were taken at the start and after 6 months of treatment. Biopsy specimens from asymptomatic smokers served as controls. RESULTS: In contrast to asthma, indices of BHR were not significantly influenced by treatment with FP. Forced expiratory volume in 1 second (FEV(1)) showed a steep decline in the placebo group but remained stable in patients treated with FP. FEV(1)/FVC, and maximal expiratory flows at 50% and 25% FVC (MEF(50), MEF(25)) were significantly increased in the FP treated patients compared with the placebo group. Biopsy specimens were analysed for the presence of CD3+, CD4+, CD8+, MBP+, CD15+, CD68+, CD1a, and tryptase cells. FP treatment resulted in marginal reductions in these indices of inflammation. CONCLUSION: In patients with COPD and BHR, FP has a positive effect on indices of lung function compared with placebo. Bronchial inflammation analysed in bronchial biopsy specimens is only marginally reduced.
G T Verhoeven; J P J J Hegmans; P G H Mulder; J M Bogaard; H C Hoogsteden; J-B Prins
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thorax     Volume:  57     ISSN:  0040-6376     ISO Abbreviation:  Thorax     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-31     Completed Date:  2002-09-12     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  694-700     Citation Subset:  IM    
Department of Pulmonary and Intensive Care Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
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MeSH Terms
Androstadienes / therapeutic use*
Biopsy / methods
Bronchial Hyperreactivity / drug therapy*,  physiopathology
Bronchodilator Agents / therapeutic use*
Double-Blind Method
Forced Expiratory Volume / physiology
Functional Residual Capacity / physiology
Middle Aged
Peak Expiratory Flow Rate / physiology
Pulmonary Disease, Chronic Obstructive / drug therapy*,  physiopathology
Vital Capacity / physiology
Reg. No./Substance:
0/Androstadienes; 0/Bronchodilator Agents; 90566-53-3/fluticasone

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

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