Effects of inhaled budesonide on the relationships between symptoms, lung function indices and airway hyperresponsiveness in patients with allergic asthma.
Fourteen patients with allergic asthma and exercise-induced bronchoconstriction (EIB) completed this study. Effects of a 6-week treatment with inhaled budesonide, daily dose 4 x 0.1 mg, were compared to the effects of treatment with placebo on patient symptom score, clinical assessment score, additional beta 2-agonist use, lung function indices, PC20 histamine and degree of EIB. Furthermore, relationships between these parameters during treatment with placebo and budesonide were analysed. Treatment with budesonide significantly improved symptom scores, FEV1 and morning peak expiratory flow rate (PEFR). A clear decrease in additional beta 2-agonist use was observed. PC20 histamine increased significantly, whereas EIB decreased significantly. Patient symptom scores and clinical assessment scores showed a significant correlation before and after treatment. No relationship was observed between these scores and other parameters, except for nocturnal dyspnoea/wheeze correlating significantly with beta 2-agonist use before treatment with budesonide. There was a significant correlation between beta 2-agonist use before treatment with budesonide and FEV1, morning PEFR, diurnal variation in PEFR, PC20 histamine and EIB. During treatment with budesonide only a significant correlation of beta 2-agonist use with PC20 histamine remained. FEV1 before treatment correlated with PEFR, diurnal variation in PEFR and EIB significantly. During treatment with budesonide the relationship of FEV1 with EIB was no longer observed. Diurnal variation in PEFR correlated with EIB significantly only before treatment. It is concluded that symptom scores are of little value in contrast to the measurement of beta 2-agonist use, lung function indices and airway hyperresponsiveness in the assessment of asthma patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Molema
J
J
Department of Pulmonary Diseases, University of Nymegen, Groesbeek, The Netherlands.
van Herwaarden
C L
CL
Folgering
H T
HT
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019819:Budesonide; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D011282:Pregnenediones / Q000008:administration & dosage / Q000627:therapeutic use*; D012129:Respiratory Function Tests; D012130:Respiratory Hypersensitivity / Q000188:drug therapy* / Q000503:physiopathology; D016037:Single-Blind Method
D001993:Bronchodilator Agents; D011282:Pregnenediones; D019819:Budesonide