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Once-daily inhaled glucocorticosteroid administration in controlled asthma patients.

AbstractBACKGROUND:
Inhaled glucocorticosteroids are usually administered in two equal daily doses. To simplify the method of treatment, once-daily administration has been used. However, little information regarding whether once-daily treatment can sufficiently control airway inflammation is available. We aimed to investigate whether once-daily administration of inhaled glucocorticosteroids can control airway inflammation.
METHODS:
Twenty-four well-controlled asthma patients were enrolled in a randomized crossover trial to compare the efficacies of once-daily and twice-daily administration of inhaled glucocorticosteroids. Initially, the patients were randomly assigned to receive either once-daily or twice-daily administration for 16 weeks. After an 8-week washout period, patients who originally received twice-daily administration were assigned to once-daily administration for 16 weeks and vice versa. We assessed the changes in the forced expiratory volume in 1s, morning and evening peak expiratory flows, asthma symptoms, health-related quality of life and fractional exhaled nitric oxide levels.
RESULTS:
Patients with once-daily administration showed the same level of clinical control and lung functions as patients receiving twice-daily administration. There was no difference in the fractional exhaled nitric oxide levels between the beginning and end of the twice-daily treatment (35.69 and 33.23ppb, respectively). In contrast, the fractional exhaled nitric oxide level was significantly higher at the end of the once-daily treatment (33.87 and 39.38ppb, respectively, p< 0.001).
CONCLUSION:
Although once-daily administration is sufficient for clinical control of asthma, it might not control airway inflammation sufficiently.
AuthorsHirotsugu Hasegawa, Naoki Inui, Tomoyuki Fujisawa, Jun Sato, Hirotoshi Nakamura, Hiroshi Watanabe, Takafumi Suda, Kingo Chida
JournalPulmonary pharmacology & therapeutics (Pulm Pharmacol Ther) Vol. 21 Issue 4 Pg. 663-7 (Aug 2008) ISSN: 1094-5539 [Print] England
PMID18479954 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Glucocorticoids
  • Nitric Oxide
  • Budesonide
  • Beclomethasone
Topics
  • Administration, Inhalation
  • Adult
  • Aged
  • Asthma (drug therapy)
  • Beclomethasone (administration & dosage, therapeutic use)
  • Breath Tests
  • Budesonide (administration & dosage, therapeutic use)
  • Cross-Over Studies
  • Drug Administration Schedule
  • Female
  • Forced Expiratory Volume (drug effects)
  • Glucocorticoids (administration & dosage, therapeutic use)
  • Humans
  • Male
  • Middle Aged
  • Nitric Oxide (metabolism)
  • Quality of Life

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