Document Detail


Thirteen-year follow-up of early intervention with an inhaled corticosteroid in patients with asthma.
MedLine Citation:
PMID:  20004779     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In a 3-year study, adult patients who recently developed asthma (symptoms for less than 1 year) were treated for 2 years with the inhaled corticosteroid (ICS) budesonide (early therapy) or terbutaline. During the third year of the study, terbutaline-treated patients received budesonide (delayed therapy). Differences in lung function and bronchial responsiveness to histamine were observed between the 2 groups. OBJECTIVE: We compared the effects of early versus delayed budesonide therapy after a 10-year follow-up period (13 years after the study began) and current real-life data. METHODS: Of the original 103 patients, 90 were re-examined 13 years after study initiation. After the third year of the study, all patients had their medications, including the dose of ICS, individually adjusted. RESULTS: After the follow-up period, lung function was within the normal range for the entire group (all patients); bronchial responsiveness significantly improved compared with baseline data. No statistically significant differences in clinical or functional variables were found between patients given early or delayed budesonide therapy. However, the delayed therapy group had a higher neutrophil count and higher concentrations of eosinophilic cationic protein and myeloperoxidase in induced sputum. This group had also used more asthma medication and hospital days. CONCLUSIONS: Patients with relatively mild asthma who received ICS within 12 months of their first asthma symptoms or after a 2-year delay achieved equally good functional control of asthma after 10 years of individualized therapy. However, the delayed therapy group exhibited slightly less optimal disease control and more signs of airway inflammation.
Authors:
Tari Haahtela; Klaus Tamminen; Tuomo Kava; L Pekka Malmberg; Paula Rytilä; Kurt Nikander; Tore Persson; Olof Selroos
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  124     ISSN:  1097-6825     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1180-5     Citation Subset:  AIM; IM    
Affiliation:
Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland. tari.haahtela@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Anti-Asthmatic Agents / administration & dosage,  therapeutic use*
Asthma / drug therapy*,  immunology
Bronchodilator Agents / administration & dosage,  therapeutic use*
Budesonide / administration & dosage,  therapeutic use*
Double-Blind Method
Female
Follow-Up Studies
Humans
Lung / immunology,  pathology
Male
Middle Aged
Sputum / immunology,  metabolism
Terbutaline / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Asthmatic Agents; 0/Bronchodilator Agents; 23031-25-6/Terbutaline; 51333-22-3/Budesonide
Comments/Corrections
Comment In:
J Allergy Clin Immunol. 2009 Dec;124(6):1186-7   [PMID:  20004780 ]

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


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