Potential Masking of Airway Eosinophilic Inflammation by Combination Therapy in Asthma.
10.4168/aair.2014.6.2.175
- Author:
Byung Jae LEE
1
;
Yun Jin JEUNG
;
Jin Young LEE
;
Mi Jung OH
;
Dong Chull CHOI
Author Information
1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dcchoi@skku.edu
- Publication Type:Brief Communication ; Randomized Controlled Trial
- Keywords:
Airway;
inflammation;
asthma;
corticosteroids;
beta2-agonists
- MeSH:
Adrenal Cortex Hormones;
Asthma*;
Budesonide;
Cross-Over Studies;
Eosinophilia;
Eosinophils*;
Humans;
Inflammation*;
Lung;
Masks*;
Methods;
Nebulizers and Vaporizers;
Prospective Studies;
Sputum
- From:Allergy, Asthma & Immunology Research
2014;6(2):175-178
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Long-acting beta2 agonists (LABA) may mask ongoing bronchial inflammation, leaving asthmatic patients at greater risk of severe complications. The aim of this study was to compare the effect of combination therapy using low-dose inhaled corticosteroids (ICS) plus LABA on airway inflammation in asthma to the effect of medium-dose ICS alone. METHODS: Twenty-four patients with asthma not controlled by low-dose (400 microg per day) budesonide alone were enrolled in this prospective crossover study. Patients were randomized into 2 treatment phases: one receiving medium-dose (800 microg per day) budesonide (ICS phase), and the other receiving a combination therapy of low-dose budesonide/formoterol (360 microg/9 microg per day) delivered by a single inhaler (LABA phase). Each treatment phase lasted for 6 week, after which patients were crossed over. Asthma symptoms, lung function, and airway inflammation were compared between the 2 phases. RESULTS: Twenty-three patients completed the study; adequate sputum samples were collected from 17 patients. Asthma symptoms and lung function remained similar between the 2 phases. However, the mean sputum eosinophil percentage was higher in the LABA phase than in the ICS phase (5.07+/-3.82% vs. 1.02+/-1.70%; P<0.01). Sputum eosinophilia (> or =3%) was more frequently observed in the LABA phase than in the ICS phase (six vs. two). CONCLUSION: Addition of LABA may mask airway eosinophilic inflammation in asthmatic patients whose symptoms are not controlled with low-dose ICS.
