title: [Study of personal best value of peak expiratory flow in patients with asthma--comparison of the highest value of daily PEF under good control and the highest value of daily PEF obtained after using repeated inhaled beta2-agonist during high-dose inhaled steroid treatment].
abstract: BACKGROUND
  In the guideline for asthma management, it is important to find the personal best value of peak expiratory flow (best PEF). Recently, we have substituted the highest value of PEF in daily life under good control (daily highest PEF) for the best PEF.
  
  
  OBJECTIVE
  In the present study, we considered whether the daily highest PEF could be used as the best PEF or not.
  
  
  METHODS
  Subjects were 30 asthmatics who were well controlled but whose baseline PEF values were less than 80 percent of predicted values. We compared the daily highest PEF and the highest of PEF obtained after repeated inhaled beta2-agonist (salbutamol MDI every 20 minutes three times). All subjects then received 1600 microg/day of beclomethasone dipropionate (BDP) for 4 to 8 weeks. We studied the effect of high-dose inhaled steroid treatment on each PEF value and compared the daily highest PEF and the highest PEF obtained after using repeated salbutamol MDI during high dose inhaled steroid therapy on the examination day again.
  
  
  RESULTS
  The baseline PEF, daily highest PEF and the highest PEF obtained after salbutamol MDI were significantly less than the each values obtained after high-dose BDP. The best PEF value of them was the value obtained after repeated salbutamol MDI during high dose BDP.
  
  
  CONCLUSIONS
  We suggest that the daily highest PEF under good control is not a substitute for best PEF because it changes according to the degree of improvement of airway inflammation. We recommend that a course of high dose inhaled steroid is effective in finding the best value of PEF for each individual with moderate asthma.
authors.affiliation: Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University School of Medicine. drnaotow@jiu.ac.jp
authors.forename: Naoto
authors.initials: N
authors.lastname: Watanabe
authors.forename: Sohei
authors.initials: S
authors.lastname: Makino
authors.forename: Norio
authors.initials: N
authors.lastname: Kihara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000318:Adrenergic beta-Agonists; D000420:Albuterol