Extrafine compared to non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma

Claire A. Cox*, Ilse M. Boudewijn, Sebastiaan J. Vroegop, Siebrig Schokker, Anne J. Lexmond, Henderik W. Frijlink, Paul Hagedoorn, Judith M. Vonk, Martijn P. Farenhorst, Nick H.T. Ten Hacken, Huib A.M. Kerstjens, Dirkje S. Postma, Maarten van den Berge

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

9 Citaten (Scopus)
3 Downloads (Pure)


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.

Originele taal-2English
Pagina's (van-tot)35-42
Aantal pagina's8
TijdschriftRespiratory Medicine
StatusPublished - sep.-2017

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