Inhaled steroids improve quality of life in patients with steady-state bronchiectasis.
BACKGROUND
The effects of inhaled steroids upon the quality of life of patients with bronchiectasis remain unknown.


OBJECTIVE
To analyze the effect of inhaled fluticasone propionate (FP) for 6 months upon the clinical, functional, microbiological and outcome parameters of patients with steady-state bronchiectasis not due to cystic fibrosis, and its repercussions for patient health-related quality of life (HRQoL).


METHODS
Prospective, randomized, double-blind (for effective doses) study.


METHODS
The diagnosis of bronchiectasis was made by high-resolution computed tomography. Ninety-three patients (mean age: 68.5 [8.4]) were randomized to receive 250 microg bid, 500 microg bid or no treatment with inhaled FP for 6 months. Data were collected at baseline and at 1, 3 and 6 months after the start of treatment. HRQoL was assessed using the validated Spanish version of the St. George's Respiratory Questionnaire.


RESULTS
The group administered FP 1000 microg daily showed significant improvement in dyspnea (1.03 [2.1]-1.24 [2.2] points; P = 0.01-0.04), sputum production (P = 0.001), days without cough (P = 0.02) and short-acting beta-2 agonists used (P = 0.01) from the first month of treatment, with no changes in pulmonary function, number or severity of exacerbations, or microbiological profile of the sputum. As a result, an improvement in HRQoL was seen in this group after 3 months of treatment (45.4 [14.2] vs. 40.5 [13.9]; P = 0.01).


CONCLUSIONS
Inhalatory FP 500 microg bid is effective from the first month of treatment for controlling the symptoms of patients with steady-state bronchiectasis-thus ensuring a significant improvement in HRQoL.
Martínez-García
Miguel A
MA
Pneumology Unit, Requena General Hospital, Valencia, Spain. med013413@nacom.es
Perpiñá-Tordera
Miguel
M
Román-Sánchez
Pilar
P
Soler-Cataluña
Juan Jose
JJ
D000280:Administration, Inhalation; D000368:Aged; D000730:Androstadienes / Q000008:administration & dosage*; D001987:Bronchiectasis / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D003371:Cough / Q000188:drug therapy; D004311:Double-Blind Method; D004417:Dyspnea / Q000188:drug therapy; D005260:Female; D000068298:Fluticasone; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012135:Respiratory Sounds; D014797:Vital Capacity
D000730:Androstadienes; D001993:Bronchodilator Agents; D000068298:Fluticasone