Step-down treatment from medium-dosage of budesonide/formoterol in controlled asthma

被引：11

作者：

Mori, Kazutaka ^{[1
]}

Fujisawa, Tomoyuki ^{[1
]}

Inui, Naoki ^{[2
]}

Hashimoto, Dai ^{[1
]}

Enomoto, Noriyuki ^{[1
]}

Nakamura, Yutaro ^{[1
]}

Kuroishi, Shigeki ^{[3
]}

Yokomura, Koshi ^{[4
]}

Toyoshima, Mikio ^{[5
]}

Imokawa, Shiro ^{[6
]}

Yamada, Takashi ^{[7
]}

Shirai, Toshihiro ^{[8
]}

Masuda, Masafumi ^{[9
]}

Hayakawa, Hiroshi ^{[10
]}

Chida, Kingo ^{[11
]}

Suda, Takafumi ^{[1
]}

机构：

[1] Hamamatsu Univ Sch Med, Dept Internal Med, Div 2, Higashi Ku, 1-20-1 Handayama, Hamamatsu, Shizuoka 4313192, Japan

[2] Hamamatsu Univ Sch Med, Dept Clin Pharmacol & Therapeut, Higashi Ku, 1-20-1 Handayama, Hamamatsu, Shizuoka 4313192, Japan

[3] Ensyu Hosp, Dept Resp Med, Naka Ku, 1-1-1 Chuou., Hamamatsu, Shizuoka 4300929, Japan

[4] Seirei Mikatahara Gen Hosp, Dept Resp Med, Kita Ku, 3453 Mikatahara Cho, Hamamatsu, Shizuoka 4338558, Japan

[5] Hamamatsu Rosai Hosp, Dept Resp Med, Higashi Ku, 25 Shougen Cho, Hamamatsu, Shizuoka 4308525, Japan

[6] Iwata City Hosp, Dept Resp Med, 513-2 Ohkubo, Iwata 4388550, Japan

[7] Shizuoka City Shizuoka Hosp, Dept Resp Med, Aoi Ku, 10-93 Ote Cho, Shizuoka 4208630, Japan

[8] Shizuoka Prefectural Gen Hosp, Dept Resp Med, Aoi Ku, 4-27-1 Kita Ando, Shizuoka 4200881, Japan

[9] Shizuoka City Shimizu Hosp, Dept Resp Med, Shimizu Ku, 1231 Miyakami, Shizuoka 4248636, Japan

[10] Natl Hosp Org, Tenryu Hosp, Dept Resp Med, Hamakita Ku, 4201-2 Oro, Hamamatsu, Shizuoka 4348511, Japan

[11] Hamamatsu Toyooka Hosp, Dept Internal Med, Kita Ku, 110 Toyooksa Cho, Hamamatsu, Shizuoka 4338103, Japan

来源：

RESPIRATORY MEDICINE | 2016年 / 119卷

关键词：

Asthma; Step-down; Long acting beta agonists; Pulmonary function; Inhaled corticosteroid; EXHALED NITRIC-OXIDE; JAPANESE GUIDELINE; PERSISTENT ASTHMA; SINGLE INHALER; INFLAMMATION;

D O I：

10.1016/j.rmed.2016.08.007

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The stepping down of asthma treatment can be considered when asthma symptoms have been well controlled with inhaled corticosteroids (ICSs)/long-acting beta 2 adrenergic agonists (LABAs). However, few data are available comparing the efficacy between two step-down strategies, to reduce ICS/LABA dose or to withdraw LABA continuing ICS, in well-controlled asthmatics. Methods: This, was a prospective multicentre randomized, two-arm, controlled study. Ninety-one asthmatic patients controlled by budesonide/formoterol combination (BFC) 320/9 mu g twice daily were assigned to 2 stepping-down treatments as follows: the BFC group; BUD/FM 160/4.5 mu g twice daily, and the ICS group; ICS (budesonide 400 mu g twice daily or equivalent dose of ICS) without LABA, and followed for 12 weeks. The primary outcome was the incidence of asthma exacerbations. Asthma control, pulmonary function tests, and fraction of exhaled nitric oxide (FeNO) were evaluated at the beginning and end of the period. Results: The incidence of exacerbations was 163% in the BFC groups and 12.5% in the ICS group, which were not different between the groups (p = 0.766). No significant differences were found in QOL score and FeNO between 0 week and 12 week in the both group. FEV1 and FEV1 percentage of the predicted value were lower at week 12 than at week 0 in the ICS group, but not in the BFC group. Conclusions: The two step-down strategies for 12 weeks have equal acceptability in well-controlled asthmatics treated with medium-dose of BFC, however, withdrawal of LABA may have potential risk to deteriorate FEV1. Clinical trial registration: This study was registered to UMIN-LIK. (http://www.umin.ac.jp/ctr/), UMIN000010333. (C) 2016 Elsevier Ltd. All rights reserved.

引用

页码：1 / 6

页数：6

共 25 条

[1] Switching from salmeterol/fluticasone to formoterol/budesonide combinations improves peripheral airway/alveolar inflammation in asthma [J].