Troleandomycin has been reported to be useful for reducing the
steroid requirement of patients with
asthma. The purpose of this study was to evaluate the usefulness of
troleandomycin in treating patients with
steroid-dependent
asthma as well as in patients with
steroid-dependent
chronic obstructive pulmonary disease (
COPD). Twelve patients with obstructive airway disease were studied; 6 patients had a diagnosis of
asthma, and 6 patients had
COPD. All had failed previous attempts to reduce their dosage of
steroids. Among the patients with
asthma, it was possible to taper
methylprednisolone dosage from 29.3 +/- 21.8 mg to 11.1 +/- 7.4 11.1 mg (P less than .05). In the group with
COPD there was also a significant decrease in
steroid dosage--from 22.6 +/- 12.2 to 6.0 +/- 4.5 mg. These changes were not associated with a decline in spirometric values; nor was improvement secondary to improved
theophylline levels, as demonstrated by a significant decrease in serum
theophylline levels from 12.4 +/- 3.6 mg/dL baseline to 8.5 +/- 2.8 mg/dL (P less than .001) after maximal
steroid tapering. We conclude that
troleandomycin is effective in reducing the
steroid dosage in patients with
COPD or
asthma.