Source: Annual Congress 2002 - Asthma - Therapy and management -3
Disease area: Airway diseases

Abstract

It is necessary to find out new strategies for the treatment of steroid-dependent asthmatic patients patients. One of possible ways - the alkylating drug administration - is limited because of the serious side effects. In therapeutic doses alkylating drugs lead to DNA-DNA cross-linkage with cytostatic effect, but, previously, it has been shown that alkylating drugs in the very low dose affect the cytokine receptors without DNA damage (such as receptors for IL-2). We have first proposed new method of treatment of asthma with the inhalations of ultra-low (non-cytotoxic) doses of alkylating drug (Melphalan). 52 patients with moderate and severe steroid-dependant asthma were divided into two groups: 26 asthmatics of Melphalan-treated group (MTG) were treated with standard therapy plus inhalations of 0,1 mg of Melphalan daily during 5 days, 26 patients of control group (CG) received only standard therapy plus placebo inhalations. Based on laboratory and clinical data we concluded that inhalations of ultra-low doses of Melphalan have the anti-inflammatory effect, resulting in bronchial epithelium regeneration and clinical improvement. The 5-years results proved, that there were no side-effects during the study; there were positive changes in 69% of patients: reducing of exacerbation severity, number of β-agonist inhalations markedly reduced in MTG. Positive dynamics of lung ventilation parameters (p<0,05) and tolerance of physical load was also revealed in MTG during on an average 6 months, while changes in the CG were unreliable. These data suggest that combined therapy with Melphalan and basic therapy is safe method of asthma treatment and offeres significant benefit over basic therapy alone.

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E. I. Sokolov, K. A. Zykov, A. L. Pukhalsky, V. I. Shevelev (Moscow, Russia). The inhalation of very low doses of alkylating drug as the treatment of severe asthma: five-year results. Eur Respir J 2002; 20: Suppl. 38, 449

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