TY - JOUR
T1 - Extrafine compared to non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma
AU - Cox, Claire A.
AU - Boudewijn, Ilse M.
AU - Vroegop, Sebastiaan J.
AU - Schokker, Siebrig
AU - Lexmond, Anne J.
AU - Frijlink, Henderik W.
AU - Hagedoorn, Paul
AU - Vonk, Judith M.
AU - Farenhorst, Martijn P.
AU - Ten Hacken, Nick H.T.
AU - Kerstjens, Huib A.M.
AU - Postma, Dirkje S.
AU - van den Berge, Maarten
PY - 2017/9
Y1 - 2017/9
N2 - Background: Smoking is as prevalent in asthmatics as in the general population. Asthmatic smokers benefit less from inhaled corticosteroids (ICS) than non-smoking asthmatics, possibly due to more smoking-induced small airways disease. Thus targeting small airways may be important in treating asthmatic (ex-) smokers. We hypothesized that extrafine particle ICS improve small airways function more than non-extrafine particle ICS in asthmatic (ex-) smokers. Methods: We performed an open-label, randomized, three-way cross-over study comparing extrafine beclomethasone (HFA-QVAR) to non-extrafine beclomethasone (HFA-Clenil) and fluticasone (HFA-Flixotide) in 22 smokers and 21 ex-smokers with asthma (>= 5 packyears).Results: Improvement from baseline in PD20 adenosine after using QVAR, Clenil or Flixotide was 1.04 +/- 1.71, 1.09 +/- 2.12 and 0.94 +/- 1.97 doubling doses, mean +/- standard deviation (SD), respectively. The change from baseline in R-5-R-20 at PD20 adenosine after using QVAR, Clenil or Flixotide was -0.02 +/- 0.27, 0.02 +/- 0.21, and -0.02 +/- 0.31 kPa sL(-1), mean +/- SD, respectively. The change in PD20 adenosine and R5R20 at PD20 adenosine were neither statistically significant different between QVAR and Clenil (p = 0.86 and p = 0.82) nor between QVAR and Flixotide (p = 0.50 and p = 0.96).Conclusion: Similar effectiveness in improving small airways function was found for extrafine and non-extrafine particle ICS treatment for asthmatic smokers and ex-smokers. (C) 2017 Elsevier Ltd. All rights reserved.
AB - Background: Smoking is as prevalent in asthmatics as in the general population. Asthmatic smokers benefit less from inhaled corticosteroids (ICS) than non-smoking asthmatics, possibly due to more smoking-induced small airways disease. Thus targeting small airways may be important in treating asthmatic (ex-) smokers. We hypothesized that extrafine particle ICS improve small airways function more than non-extrafine particle ICS in asthmatic (ex-) smokers. Methods: We performed an open-label, randomized, three-way cross-over study comparing extrafine beclomethasone (HFA-QVAR) to non-extrafine beclomethasone (HFA-Clenil) and fluticasone (HFA-Flixotide) in 22 smokers and 21 ex-smokers with asthma (>= 5 packyears).Results: Improvement from baseline in PD20 adenosine after using QVAR, Clenil or Flixotide was 1.04 +/- 1.71, 1.09 +/- 2.12 and 0.94 +/- 1.97 doubling doses, mean +/- standard deviation (SD), respectively. The change from baseline in R-5-R-20 at PD20 adenosine after using QVAR, Clenil or Flixotide was -0.02 +/- 0.27, 0.02 +/- 0.21, and -0.02 +/- 0.31 kPa sL(-1), mean +/- SD, respectively. The change in PD20 adenosine and R5R20 at PD20 adenosine were neither statistically significant different between QVAR and Clenil (p = 0.86 and p = 0.82) nor between QVAR and Flixotide (p = 0.50 and p = 0.96).Conclusion: Similar effectiveness in improving small airways function was found for extrafine and non-extrafine particle ICS treatment for asthmatic smokers and ex-smokers. (C) 2017 Elsevier Ltd. All rights reserved.
KW - AMP
KW - Dry powder adenosine
KW - ICS
KW - Provocation
KW - Small airways
KW - DRY POWDER INHALATION
KW - SMALL AIRWAYS
KW - BECLOMETHASONE DIPROPIONATE
KW - SMOKING
KW - METHACHOLINE
KW - FORMULATION
KW - THERAPY
KW - HYPERRESPONSIVENESS
KW - INFLAMMATION
KW - INVOLVEMENT
U2 - 10.1016/j.rmed.2017.07.005
DO - 10.1016/j.rmed.2017.07.005
M3 - Article
C2 - 29206631
SN - 0954-6111
VL - 130
SP - 35
EP - 42
JO - Respiratory Medicine
JF - Respiratory Medicine
ER -