title: Is it necessary to treat mild asthmatic patients with the full dose treatment?
abstract: BACKGROUND
  Routine protocol of asthma treatment has been focused on symptom suppression but severity of inflammation and spirometry findings may be neglected. We investigated the efficacy of full dose treatment protocol on patients with mild asthma symptoms with normal spirometry.
  
  
  METHODS
  A before-after clinical trial study was conducted on patients with asthma symptoms (dyspnea, cough, and wheezing), while they had a near to normal pulmonary function test. Full dose treatment protocol (prednisolone 1 mg/kg for 5 days then fluticasone spray 250 mg four puffs daily plus salmeterol spray 25 mg four puffs daily), which was routinely used for severe asthma, was administrated and patients were followed up for 2 months.
  
  
  RESULTS
  Sixty-eight patients (mean age (±SD) = 43.77 ± 10.70 years, female/male ratio; 47/53%) finally finished the study. At the baseline, mean forced expiratory volume in first second (FEV1) and forced vital capacity (FVC) were 91 ± 12% and 87 ± 11% of the predicted value, respectively. Two months after treatment, the mean FEV1 and FVC were 105 ± 14% and 97 ± 10%, respectively, which both improved compared with the baseline, significantly (P < 0.001). Frequencies of cough and dyspnea were significantly decreased (P = 0.041 and 0.034, respectively).
  
  
  CONCLUSIONS
  Our result declared that full dose treatment can improve spirometry amounts and frequency of symptoms in patients with near to normal spirometry and obvious asthmatic symptoms. Routine treatment protocol of mild asthma recommends sole short-acting b2 receptor agonist, but it seems that pulmonary function and volume can be increased with more aggressive treatment.
authors: Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors: Ali
authors: A
authors: Haji-Hashemi
authors: Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors: Ensiyeh
authors: E
authors: Vahedi
authors: Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran ; Atherosclerosis and Coronary Artery Research Centre, Birjand University of Medical Sciences, Birjand, Islamic Republic of Iran.
authors: Amin
authors: A
authors: Saburi
authors: Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors: Mostafa
authors: M
authors: Ghanei
keywords: Asthma; clinical findings; full dose treatment; mild asthma; signs and symptoms; spirometry; treatment