Responses to bronchial challenge submitted for approval to use inhaled beta2-agonists before an event at the 2002 Winter Olympics.
BACKGROUND
There has been an increase in the number and percentage of athletes competing in Olympic Games notifying use of beta2-agonists, from 1.7% at Los Angeles (1984) to 5.5% at Sydney (2000). For Salt Lake City (2002), the International Olympic Committee requested objective evidence to use beta2-agonists for asthma or exercise-induced asthma (EIA).


OBJECTIVE
The objective of this study was to evaluate the evidence submitted for approval to use a beta2-agonist.


METHODS
Objective evidence for asthma or EIA included (1) an increase of 12% or more of the predicted FEV1 in response to bronchodilator, (2) a reduction in FEV1 of 10% or greater from baseline in response to exercise or eucapnic voluntary hyperpnea, (3) a PD20 FEV1 to methacholine or histamine at a dose of less than 200 microg (2 mg/mL) or less than 1320 microg (13.2 mg/mL) for those taking inhaled corticosteroids for 3 months.


RESULTS
There were 165 applications. Of these, 147 (89%) included evidence of a challenge, bronchodilator response, or both, and 163 test results were submitted. One hundred thirty (5.2%) applications were approved. For those with positive responses, the median value (1) was 16.2% of predicted FEV1 for response to a bronchodilator (n = 13), (2) was a 15.9% decrease in FEV1 for response to a physical challenge (n = 36), and, (3) for PD20 FEV1, was 173 microg for response to a pharmacologic challenge (n = 45).


CONCLUSIONS
The analysis demonstrated that it is feasible to request objective evidence to justify use of beta2-agonists on the medical grounds of asthma or EIA.
Anderson
Sandra D
SD
Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Fitch
Kenneth
K
Perry
Clare P
CP
Sue-Chu
Malcolm
M
Crapo
Robert
R
McKenzie
Donald
D
Magnussen
Helgo
H
D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D001985:Bronchial Provocation Tests; D016084:Bronchoconstriction / Q000187:drug effects; D017277:Drug Approval; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D012621:Seasons; D013177:Sports
D000318:Adrenergic beta-Agonists