Episodic asthma as a bronchial provocation test.
This study, originally designed to investigate the efficacy of a new inhaled steroid, flunisolide, in New Orleans, demonstrated that episodic asthma (known as "New Orleans Asthma") still occurs in that city. Although its outbreaks are less frequent and severe than reported in previous years, they are still intense enough to affect asthmatics who are on maximal drug therapy. We found in this study that patients who were taking a sympathomimetic, methyl xanthine, and steroids both by inhalation (flunisolide) and by mouth (prednisone) required more prednisone during outbreaks. During such outbreaks the use of flunisolide not only delayed the need for more prednisone but also reduced the dosage needed. Furthermore, flunisolide had over-all prednisone-sparing benefits during the course of the whole 18-week study. Finally, throughout the study, asthma was less frequent in patients on flunisolide therapy, their over-all therapeutic response being significantly better than that of a control group. The authors conclude that New Orleans Asthma provides a natural provocation for extrinsic asthmatics in their normal milieu and thus provides an ideal situation for testing new anti-asthmatic treatments, especially in individuals with severe asthma in whom deliberate challenge may be unethical.
D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D001772:Blood Cell Count; D001985:Bronchial Provocation Tests; D002176:Candida albicans; D005260:Female; D005446:Fluocinolone Acetonide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011241:Prednisone / Q000627:therapeutic use; D013997:Time Factors; D014556:Urine
D010919:Placebos; D005446:Fluocinolone Acetonide; C007734:flunisolide; D011241:Prednisone; D006854:Hydrocortisone