title: The Predicting Response to Inhaled Corticosteroid Efficacy (PRICE) trial.
abstract: BACKGROUND
  Although guidelines recommend anti-inflammatory therapy for persistent asthma, recent studies suggest that 25% to 35% of patients with asthma may not improve lung function with inhaled corticosteroids.
  
  
  OBJECTIVE
  To evaluate potential biomarkers of predicting short-term (6-week) response to inhaled corticosteroid with subsequent evaluation of responders and nonresponders to asthma control over a longer interval (16 additional weeks).
  
  
  METHODS
  Eighty-three subjects with asthma off steroid were enrolled in this multicenter study. Biomarkers and asthma characteristics were evaluated as predictors of inhaled corticosteroid response over a 6-week trial for changes in FEV(1) and methacholine PC(20). After this, an additional 4-month trial evaluated asthma control.
  
  
  RESULTS
  Although multiple baseline predictors had significant correlations with improvements for short-term inhaled steroid success, the only strong correlations (r >or= +/- 0.6) were albuterol reversibility (r = 0.83; P < .001), FEV(1)/forced vital capacity (r = -0.75; P < .001), and FEV(1) % predicted (r = -0.71; P < .001). Dividing the subjects in the short-term inhaled steroid trial into responders (>5% FEV(1) improvement) and nonresponders (<or=5%) determined the longer-term need for steroids. For the nonresponders, asthma control remained unchanged whether inhaled corticosteroids were continued or were substituted with a placebo (P = .99). The good short-term responders maintained asthma control longer-term only if maintained on inhaled steroids (P = .007).
  
  
  CONCLUSIONS
  The short-term response to inhaled corticosteroids with regard to FEV(1) improvement predicts long-term asthma control.
  
  
  CONCLUSIONS
  The decision to use long-term inhaled steroids could be based on a short-term trial. Different therapeutic strategies would need to be established for nonresponders.
authors.affiliation: National Jewish Medical and Research Center, Denver, CO 80206, USA. martinr@njc.org
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Martin
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Szefler
authors.forename: Tonya S
authors.initials: TS
authors.lastname: King
authors.forename: Monica
authors.initials: M
authors.lastname: Kraft
authors.forename: Homer A
authors.initials: HA
authors.lastname: Boushey
authors.forename: Vernon M
authors.initials: VM
authors.lastname: Chinchilli
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Craig
authors.forename: Emily A
authors.initials: EA
authors.lastname: Dimango
authors.forename: Aaron
authors.initials: A
authors.lastname: Deykin
authors.forename: John V
authors.initials: JV
authors.lastname: Fahy
authors.forename: Elliot
authors.initials: E
authors.lastname: Israel
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Lazarus
authors.forename: Robert F
authors.initials: RF
authors.lastname: Lemanske
authors.forename: Frank T
authors.initials: FT
authors.lastname: Leone
authors.forename: Gene R
authors.initials: GR
authors.lastname: Pesola
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Peters
authors.forename: Christine A
authors.initials: CA
authors.lastname: Sorkness
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Szwejbka
authors.forename: Michael E
authors.initials: ME
authors.lastname: Wechsler
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001507:Beclomethasone / Q000627:therapeutic use*; D015415:Biomarkers; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents; D015415:Biomarkers; D001507:Beclomethasone