title: Once-daily inhaled glucocorticosteroid administration in controlled asthma patients.
abstract: BACKGROUND
  Inhaled glucocorticosteroids are usually administered in two equal daily doses. To simplify the method of treatment, once-daily administration has been used. However, little information regarding whether once-daily treatment can sufficiently control airway inflammation is available. We aimed to investigate whether once-daily administration of inhaled glucocorticosteroids can control airway inflammation.
  
  
  METHODS
  Twenty-four well-controlled asthma patients were enrolled in a randomized crossover trial to compare the efficacies of once-daily and twice-daily administration of inhaled glucocorticosteroids. Initially, the patients were randomly assigned to receive either once-daily or twice-daily administration for 16 weeks. After an 8-week washout period, patients who originally received twice-daily administration were assigned to once-daily administration for 16 weeks and vice versa. We assessed the changes in the forced expiratory volume in 1s, morning and evening peak expiratory flows, asthma symptoms, health-related quality of life and fractional exhaled nitric oxide levels.
  
  
  RESULTS
  Patients with once-daily administration showed the same level of clinical control and lung functions as patients receiving twice-daily administration. There was no difference in the fractional exhaled nitric oxide levels between the beginning and end of the twice-daily treatment (35.69 and 33.23ppb, respectively). In contrast, the fractional exhaled nitric oxide level was significantly higher at the end of the once-daily treatment (33.87 and 39.38ppb, respectively, p< 0.001).
  
  
  CONCLUSIONS
  Although once-daily administration is sufficient for clinical control of asthma, it might not control airway inflammation sufficiently.
authors.affiliation: The Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Inui
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujisawa
authors.forename: Jun
authors.initials: J
authors.lastname: Sato
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Takafumi
authors.initials: T
authors.lastname: Suda
authors.forename: Kingo
authors.initials: K
authors.lastname: Chida
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D001944:Breath Tests; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use; D018592:Cross-Over Studies; D004334:Drug Administration Schedule; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism*; D011788:Quality of Life
chemical_list: D005938:Glucocorticoids; D009569:Nitric Oxide; D019819:Budesonide; D001507:Beclomethasone