Regularly inhaled beta-agonists with steroids are not harmful in stable asthma.
Regular use of inhaled beta-agonists with steroids was not harmful in stable asthma. Morning and evening peak expiratory flow (PEF) values were recorded daily for 1 week (week 1) before regular inhalation of beta-agonists and steroids. Then beta-agonists were withdrawn and used as needed for a 2-week washout period. The PEF values of the first week (week 1) were compared with the PEF values before treatment during a further 1-week period (week 4) of as-needed use of beta-agonists. The mean evening PEF values were significantly higher (difference = 9.55 L/min; p = 0.017; 95% confidence interval [CI], 1.80 to 17.30 L/min), and the mean morning PEF values were nearly significantly higher (difference = 6.49 L/min; p = 0.088, 95% CI, -0.99 to 14.00 L/min) during regular beta-agonist use. There were significantly more patients with more symptom days, including nights with awakening, during as-needed treatment (difference in ratio of patients = 40.74%; p = 0.0001; 95% CI, 20.21% to 61.27%). When nocturnal symptoms are considered separately, there were more patients with more nights with awakening during as-needed treatment with a nearly significant difference (difference in ratio of patients = 12.96%; p = 0.0654; 95% CI, 0.92 to 25.00%). PEF monitoring should be used to distinguish the majority of patients with asthma who have higher PEF values during regular treatment from those who do better with administration of beta-agonists as needed. To deny patients with asthma regular use of small doses of beta-agonists in general is to deny individual differences among patients with asthma.
Heino
M
M
Peijas Hospital, Department of Pulmonary Medicine, Vantaa, Finland.
D000280:Administration, Inhalation; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D002940:Circadian Rhythm; D004338:Drug Combinations; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D013256:Steroids / Q000008:administration & dosage* / Q000627:therapeutic use
D000318:Adrenergic beta-Agonists; D004338:Drug Combinations; D013256:Steroids