Protection by budesonide and fluticasone on allergen-induced airway responses after discontinuation of therapy - 18/08/11
, Sandra C. Dorman, PhD, Tracey Rerecich, CMLT, Richard M. Watson, BSc, Gail M. Gauvreau, PhD, Paul M. O'Byrne, MB
Reprint requests: Padmaja Subbarao, MD, MSc, FRCP(C), Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada.Hamilton, Ontario, Canada
Abstract |
Background |
Treatment with inhaled steroids is an effective method of reducing bronchoconstriction and airway inflammation after allergen challenge. However, the durationof the protective effects of inhaled steroids after discontinuation of therapy has not been established.
Objective |
We sought to evaluate the protective effect of 1 week of inhaled steroid therapy against inhaled allergen challenge 12 hours after discontinuation of therapy.
Methods |
In this randomized, double-blind, placebo-controlled crossover trial, 26 asthmatic subjects (>18 years old) not using inhaled steroids were administered 200 μg of budesonide twice daily, 200 μg of fluticasone twice daily, or placebo twice daily for 1 week. Twelve hours after discontinuation of therapy, subjects were administered an inhaled allergen challenge. Each treatment period was separated by a 3-week washout period.
Results |
When compared with placebo (26% ± 14%), there was a slight but significant protection against the allergen-induced early response after fluticasone treatment (19% ± 10%, P=.001) but not after budesonide treatment (23% ± 13%, P=.08). However, when the area under the curve for the early airway response was examined, there was no difference between the 2 drugs in the amount of protection (P=.62). Partial protection was demonstrated against the late-response allergen-induced sputum eosinophilia with both treatments (P=.001). By contrast, no protection was observed against allergen-induced airway hyperresponsiveness for either treatment.
Conclusions |
The protective effects of inhaled steroids against allergen-induced early responses, airway eosinophilia, and allergen-induced airway hyperresponsiveness are partially or completely lost as early as 12 hours after discontinuation of therapy.
Le texte complet de cet article est disponible en PDF.Key words : Budesonide, fluticasone, steroids, asthma, allergen challenge, bronchial challenge test, sputum, eosinophils
Abbreviations used : AUC, EAR, LAR, MCh PC20
Plan
| Supported in part by Astra-Zeneca Ltd. Dr Subbarao received a research fellowship funded by the Canadian Institutes of Health Research in partnership with Merckk-Frost Canada. Disclosure of potential conflict of interest: P. Subbarao received supportfrom 2000-2001 Canadian Lung Association–Mercke-Frosst Fellowship. S. C. Dorman—none disclosed. T. Rerecich—none disclosed. R. M. Watson—none disclosed. G. Gauvreau—none disclosed. P. M. O'Byrne has consultant arrangements with Altana, AstraZeneca, GlaxoSmithKline, Topigen, and Roche and has received support from Altana, AstraZeneca, GlaxoSmithKline, Dynavax, and Pfizer. |
Vol 115 - N° 4
P. 745-750 - avril 2005 Retour au numéro
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