Inhaled glucocorticoids (GCs) are the most effective controller therapy, and are recommended treatment of persistent asthma at any step of severity. Clinical effects to inhaled GCs are various. The purpose of this study was to identify factors associated with responsiveness to high dose inhaled GCs in patients with asthma.

One hundred-four asthmatic patients aged 17 to 79 years were enrolled in prospective study. The dose of inhaled GCs used was fluticasone propionate 1000μg/d or budesonide 1600μg/d. The effect of inhaled GCs on PFT, asthma related quality of life (QOL), sputum and blood eosinophils was evaluated at baseline and at 4, 8, 12 weeks.

At 4, 8, 12 weeks, FEV1 was significantly increased following inhaled GCs. The change of FEV1 (ΔFEV1) following inhaled GCs was diverse from −30% to 85%. Blood eosinophils, FEV1 at baseline, age was independently associated with responsiveness to inhaled GCs at 4 weeks. The asthma QOL scores were improved following inhaled GCs. The asthmatic patients with greater response than 12% of FEV1, greater than 80% of accuracy of inhaler technique, and greater than 80% of compliance of inhaler were significantly shorter duration of asthma and higher proportion of blood eosinophils at baseline. ΔFEV1 was negatively correlated with FEV1 and FEV1/FVC at baseline.

Duration of asthma, blood eosinophils, and FEV1 at baseline is associated with responsiveness to inhaled GCs in patients with asthma. This work was supported by a grant from the Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (01-PJ3-PG6-01GN04-003).