title: Asthma control following initial inhaled corticosteroid monotherapy in mild to moderate asthma: a 4- to 8-week observational study.
abstract: BACKGROUND
  There is an increasing trend for the use of combination therapy of inhaled corticosteroids (ICS) and long-acting beta(2)-agonists as initial treatment for asthma.
  
  
  OBJECTIVE
  To assess the efficacy of initial monotherapy with ICS for achieving asthma control in steroid-naive mild to moderate asthmatics.
  
  
  METHODS
  During an observational survey, steroid-naive patients received ICS in a dosage of 400-2,000 mug/day. After 4-8 weeks' treatment, achievement of asthma control, defined according to the Global Initiative for Asthma (GINA) guidelines, was assessed and the Asthma Control Questionnaire (ACQ) was completed.
  
  
  RESULTS
  Among 537 selected patients, 21 were excluded because of severe asthma and 96 because of inadequate ICS daily dosage. Four hundred and twenty patients were analyzed, 396 (94%) of whom completed the survey. Mean ICS dosage, in equivalent beclomethasone, was 479 +/- 62 mug/day for mild asthma (group A) and 1,115 +/- 306 mug/day for moderate asthma (group B). Asthma control was achieved for 71 and 65% of the patients, mean ACQ score improved from 1.1 +/- 0.6 to 0.5 +/- 0.5 (p < 0.001) and from 2.0 +/- 0.8 to 0.8 +/- 0.7 (p < 0,001), and FEV(1) (% predicted) improved from 93 +/- 9 to 96 +/- 13 (p < 0.05) and from 85 +/- 15 to 91 +/- 15 (p < 0.001) for groups A and B, respectively.
  
  
  CONCLUSIONS
  Asthma control can be achieved by ICS monotherapy for two thirds of steroid-naive patients with mild to moderate asthma. For these patients, we suggest that ICS alone could be started as initial therapy and that additional therapy should be considered after 4-8 weeks for patients who do not achieve control.
authors.affiliation: Laboratoires IVAX, Neuilly-sur-Seine, France. violaine.giraud@ivax.fr
authors.forename: Violaine
authors.initials: V
authors.lastname: Giraud
authors.forename: Yves
authors.initials: Y
authors.lastname: Rogeaux
authors.forename: Daniel
authors.initials: D
authors.lastname: Dusser
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000517:prevention & control*; D001507:Beclomethasone / Q000008:administration & dosage*; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male
chemical_list: D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids; D001507:Beclomethasone