Long term benefits of inhaled corticosteroid in adults with asthma

January 01, 0001

Long term benefits of inhaled corticosteroid in adults with asthma

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. The researchers 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. 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.

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.

The researchers concluded: "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."

This supports early intervention and long-term treatment, although we have no comparative untreated group.

For the full abstract, click here.

The Journal of Allergy and Clinical Immunology 124(6):1180-1185, December 2009 © 2010 Elsevier, Inc
Thirteen-year follow-up of early intervention with an inhaled corticosteroid in patients with asthma. Tari Haahtela, Klaus Tamminen, Tuomo Kava et al. Correspondence to Tari Haahtela: [email protected]

Category: R. Respiratory. Keywords: asthma, asthma control, budesonide, early intervention, inhaled corticosteroids, prebronchodilator FEV1, terbutaline, prospective study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 28 May 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.