Fluticasone/formoterol association favors long-lasting decrease in bronchial reactivity to methacholine and weekly PEF variability.
Inhaled corticosteroids (ICS)/long-acting beta-agonists (LABA) association offers a better asthma control than a higher steroid dose with short-acting beta-agonists as needed. In this study, we evaluated the effect of the association on bronchial hyperreactivity (BHR) and peak expiratory flow (PEF) variability, as such parameters are positively correlated with increased asthma morbidity and exacerbations. Thirty-six adult patients with mild persistent asthma were enrolled. After a 7-day run-in, they were randomly assigned to three therapy regimens for 6 weeks: Group 1, fluticasone 125 μg + formoterol 5 μg in the same device; Group 2, fluticasone 125 μg + formoterol 12 μg as needed; Group 3, fluticasone 250 μg + formoterol 12 μg as needed. We evaluated changes induced in weekly PEF variability (measured during the entire study and 4 weeks of follow-up) and pre- and post-study PD20 methacholine (MCH). Weekly PEF variability decreased in all groups during treatment with the greatest reduction in Group 1, followed by Group 3, and finally Group 2. During the follow-up, no significant changes were detected in Group 1, whereas a trend towards an increased variability was found in Groups 2 and 3. Post-treatment PD20 MCH was significantly higher versus the pre-treatment. The increase observed in Group 1 was significantly higher compared to Groups 2 and 3 and that observed in Group 3 in respect to Group 2. The study proves that both BHR and PEF variability are influenced by ICS. This effect was greater with fluticasone/formoterol association compared to fluticasone alone with formoterol as needed even at higher steroid dose.
Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy.
Sara
S
Cortese
Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy.
Alessia
A
Gatta
Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy.
Loredana
L
Della Valle
Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy.
Rocco
R
Mangifesta
Department of Medical Oral and Biotechnological Science, G. d'Annunzio University, Chieti, Italy.
Luca
L
Di Giampaolo
Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy.
Enrico
E
Cavallucci
Immunotoxicology and Allergy Unit, CeSI, G. d'Annunzio University Foundation, Chieti, Italy.
Claudia
C
Petrarca
Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy.
Roberto
R
Paganelli
Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy mario.digioacchino@unich.it.|Immunotoxicology and Allergy Unit, CeSI, G. d'Annunzio University Foundation, Chieti, Italy.
Mario
M
Di Gioacchino
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000328:Adult; D001249:Asthma / Q000188:drug therapy; D016085:Bronchoconstrictor Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D005260:Female; D000068298:Fluticasone / Q000627:therapeutic use*; D000068759:Formoterol Fumarate / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D016210:Methacholine Chloride / Q000627:therapeutic use*; D010366:Peak Expiratory Flow Rate / Q000187:drug effects*
D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D016085:Bronchoconstrictor Agents; D001993:Bronchodilator Agents; D016210:Methacholine Chloride; D000068298:Fluticasone; D000068759:Formoterol Fumarate
bronchial hyperreactivity; fluticasone/formoterol association; methacholine; peak expiratory flow (PEF) variability