Source: International Congress 2015 – New data on established treatments for asthma and COPD
Disease area: Airway diseases

Abstract

Background: Long-term prognosis after inhaled corticosteroid (ICS) therapy is not well understood in adult asthma patients.Aims: We studied the time course of improvement with respect to symptoms, respiratory function, airway inflammation, and airway hyperresponsiveness during ICS therapy for ten years.Methods: The study was conducted in 67 adult patients with mild to moderate bronchial asthma. The subjects were monitored for Asthma Control Questionnaire (ACQ) score, flow volume curve, fractional exhaled nitric oxide (FeNO), induced-sputum, and airway hyperresponsiveness (AHR) during 10 years of treatment with ICS.Results: The subjects were classified into three groups: 38 subjects whose respiratory function was normal both at baseline and after 10 years (Group A), 18 subjects whose respiratory function was deteriorated at baseline but normalized after 5 years (Group B), and 11 subjects whose respiratory function was deteriorated both at baseline and after 5 years (Group C). After 5 years of ICS treatment, proportion of subjects who achieved normal ACQ, FEV1.0,%predicted, FeNO , sputum eosinophil percentage, and AHR was: 92%, 97%, 82%, 70%, and 21% in Group A, 100%, 100%, 89%, 56%, and 11% in Group B, and 82%, 0%, 82%, 56%, and 0% in Group C, respectively. After 10 years in Group A, each value was: 97%, 100%, 87%, 81%, and 34%, respectively.Conclusions: ICS therapy improves symptoms, respiratory function, airway inflammation, and airway hyperresponsiveness, in this order. However, airway hyperresponsiveness did not completely return to normal after 10 years of ICS therapy in many cases.


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Terufumi Shimoda (Fukuoka, Japan), Terufumi Shimoda, Yasushi Obase, Michiyoshi Imaoka, Reiko Kishikawa, Tomoaki Iwanaga. Changes in symptoms, respiratory function, airway inflammation, and airway hyperresponsiveness over 10 year of inhaled corticosteroid therapy in adult asthma patients. Eur Respir J 2015; 46: Suppl. 59, 1012

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