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Prediction of treatment-response to inhaled corticosteroids by mannitol-challenge test in COPD. A proof of concept

Leuppi, JD; Tandjung, R; Anderson, SD; Stolz, D; Brutsche, MH; Bingisser, R; Perruchoud, AP; Surber, C; Knoblauch, A and Andersson, Morgan LU , et al. (2005) In Pulmonary Pharmacology & Therapeutics 18(2). p.83-88
Abstract
Background: There are no predictors known that can identify COPD patients who will respond to treatment with ICS. Method: We investigated 30 patients (median age 65 (range 44-83, 12 females) with mild to moderately severe COPD. All patients had post bronchodilator FEV1/forced vital capacity ratio of less than 70% and a reversibility of less than 12% and 200 ml from baseline. We wanted to determine if airway responsiveness (AHR) to histamine and mannitol could predict who would respond to a 3-month course of ICS. Results: At baseline, all patients had AHR to histamine, but only 7 (23%) patients to mannitol. After 3 months of treatment with ICS, there was no significant change in spirometry or the quality of life when analysing all... (More)
Background: There are no predictors known that can identify COPD patients who will respond to treatment with ICS. Method: We investigated 30 patients (median age 65 (range 44-83, 12 females) with mild to moderately severe COPD. All patients had post bronchodilator FEV1/forced vital capacity ratio of less than 70% and a reversibility of less than 12% and 200 ml from baseline. We wanted to determine if airway responsiveness (AHR) to histamine and mannitol could predict who would respond to a 3-month course of ICS. Results: At baseline, all patients had AHR to histamine, but only 7 (23%) patients to mannitol. After 3 months of treatment with ICS, there was no significant change in spirometry or the quality of life when analysing all individuals together. However, FEV1 % predicted improved from 67% (IQR12) to 79% (IQR16) in mannitol positive patients; whereas it was unchanged in the mannitol negative patients. The difference in the mean change of FEV1% predicted between the two groups was 12 (IQR13.5) and this was highly significant (p=0.001). The improvement in quality of life (SGRQ 30 (IQR10.5) to 21 (IQR12; p=0.01) was only significant in the patients positive to mannitol. Conclusion: We propose that AHR to mannitol could predict ICS-responsiveness in mild to moderately severe COPD patients. (Less)
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Contribution to journal
publication status
published
subject
keywords
mannitol challenge, prediction of steroid response, COPD
in
Pulmonary Pharmacology & Therapeutics
volume
18
issue
2
pages
83 - 88
publisher
Elsevier
external identifiers
  • pmid:15649849
  • wos:000226697400002
  • scopus:19944427592
ISSN
1522-9629
DOI
10.1016/j.pupt.2004.10.005
language
English
LU publication?
yes
id
7f3f8099-f232-41b5-aa5c-2517f17e034f (old id 254058)
date added to LUP
2007-08-22 11:44:45
date last changed
2017-01-01 06:58:40
@article{7f3f8099-f232-41b5-aa5c-2517f17e034f,
  abstract     = {Background: There are no predictors known that can identify COPD patients who will respond to treatment with ICS. Method: We investigated 30 patients (median age 65 (range 44-83, 12 females) with mild to moderately severe COPD. All patients had post bronchodilator FEV1/forced vital capacity ratio of less than 70% and a reversibility of less than 12% and 200 ml from baseline. We wanted to determine if airway responsiveness (AHR) to histamine and mannitol could predict who would respond to a 3-month course of ICS. Results: At baseline, all patients had AHR to histamine, but only 7 (23%) patients to mannitol. After 3 months of treatment with ICS, there was no significant change in spirometry or the quality of life when analysing all individuals together. However, FEV1 % predicted improved from 67% (IQR12) to 79% (IQR16) in mannitol positive patients; whereas it was unchanged in the mannitol negative patients. The difference in the mean change of FEV1% predicted between the two groups was 12 (IQR13.5) and this was highly significant (p=0.001). The improvement in quality of life (SGRQ 30 (IQR10.5) to 21 (IQR12; p=0.01) was only significant in the patients positive to mannitol. Conclusion: We propose that AHR to mannitol could predict ICS-responsiveness in mild to moderately severe COPD patients.},
  author       = {Leuppi, JD and Tandjung, R and Anderson, SD and Stolz, D and Brutsche, MH and Bingisser, R and Perruchoud, AP and Surber, C and Knoblauch, A and Andersson, Morgan and Greiff, Lennart and Chan, HK and Tamm, M},
  issn         = {1522-9629},
  keyword      = {mannitol challenge,prediction of steroid response,COPD},
  language     = {eng},
  number       = {2},
  pages        = {83--88},
  publisher    = {Elsevier},
  series       = {Pulmonary Pharmacology & Therapeutics},
  title        = {Prediction of treatment-response to inhaled corticosteroids by mannitol-challenge test in COPD. A proof of concept},
  url          = {http://dx.doi.org/10.1016/j.pupt.2004.10.005},
  volume       = {18},
  year         = {2005},
}