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Asthma control and steroid doses 5 years after early or delayed introduction of inhaled corticosteroids in asthma: a real-life study

Selroos, Olof LU ; Lofroos, A B; Pietinalho, A and Riska, H (2004) In Respiratory Medicine 98(3). p.254-262
Abstract
We evaluated asthma control and medication use 5 years after introduction of an inhaled corticosteroid (budesonide via Turbuhaler(R)) in 462 patients with persistent asthma and symptoms of different duration. An early treatment group with symptoms for <2 years (group A) was compared with a delayed treatment group (group B) (median duration 5 years and 3 months). Most patients received budesonide 400 μg twice daily as initial dose. We report 5-year follow-up data on 404 patients (group A n = 253; group B n = 151) and on a few more patients after treatment for 6 months, 1 year and 3 years. At 5 years the mean maintenance doses of budesonide were 412 μg (A) and 825 μg (B), respectively (P < 0.001). Nevertheless, treatment goals (normal... (More)
We evaluated asthma control and medication use 5 years after introduction of an inhaled corticosteroid (budesonide via Turbuhaler(R)) in 462 patients with persistent asthma and symptoms of different duration. An early treatment group with symptoms for <2 years (group A) was compared with a delayed treatment group (group B) (median duration 5 years and 3 months). Most patients received budesonide 400 μg twice daily as initial dose. We report 5-year follow-up data on 404 patients (group A n = 253; group B n = 151) and on a few more patients after treatment for 6 months, 1 year and 3 years. At 5 years the mean maintenance doses of budesonide were 412 μg (A) and 825 μg (B), respectively (P < 0.001). Nevertheless, treatment goals (normal lung function, normal exercise tolerance, minimal use of reliever medication, no asthma exacerbations) were all statistically significantly more frequently achieved in group A. At 5 years group B patients also used significantly more additional asthma medications, e.g. inhaled tong-acting beta(2)-agonists by 64% compared with 6% in group A. In group A 43 patients (117%) had been able to stop budesonide treatment compared to five patients (3%) in group B. A subgroup of group B patients with higher mean baseline FEV1 values than group A showed nevertheless significantly poorer response. No treatment-related serious adverse events were reported. Budesonide was well tolerated in both groups. Conclusion: Duration of asthma symptoms when starting treatment with an inhaled corticosteroid is an important determinant for the response. Early treatment gives significantly better airway function and asthma control than delayed treatment and at tower maintenance doses. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
budesonide, asthma, early treatment, delayed treatment, goals, treatment, Turbuhaler
in
Respiratory Medicine
volume
98
issue
3
pages
254 - 262
publisher
Elsevier
external identifiers
  • pmid:15002762
  • wos:000189308200009
  • scopus:10744229116
ISSN
1532-3064
DOI
10.1016/j.rmed.2003.10.007
language
English
LU publication?
yes
id
a59a0ce2-128c-4488-902a-aa3790955fe7 (old id 285726)
date added to LUP
2007-10-26 13:51:33
date last changed
2017-10-01 04:36:53
@article{a59a0ce2-128c-4488-902a-aa3790955fe7,
  abstract     = {We evaluated asthma control and medication use 5 years after introduction of an inhaled corticosteroid (budesonide via Turbuhaler(R)) in 462 patients with persistent asthma and symptoms of different duration. An early treatment group with symptoms for &lt;2 years (group A) was compared with a delayed treatment group (group B) (median duration 5 years and 3 months). Most patients received budesonide 400 μg twice daily as initial dose. We report 5-year follow-up data on 404 patients (group A n = 253; group B n = 151) and on a few more patients after treatment for 6 months, 1 year and 3 years. At 5 years the mean maintenance doses of budesonide were 412 μg (A) and 825 μg (B), respectively (P &lt; 0.001). Nevertheless, treatment goals (normal lung function, normal exercise tolerance, minimal use of reliever medication, no asthma exacerbations) were all statistically significantly more frequently achieved in group A. At 5 years group B patients also used significantly more additional asthma medications, e.g. inhaled tong-acting beta(2)-agonists by 64% compared with 6% in group A. In group A 43 patients (117%) had been able to stop budesonide treatment compared to five patients (3%) in group B. A subgroup of group B patients with higher mean baseline FEV1 values than group A showed nevertheless significantly poorer response. No treatment-related serious adverse events were reported. Budesonide was well tolerated in both groups. Conclusion: Duration of asthma symptoms when starting treatment with an inhaled corticosteroid is an important determinant for the response. Early treatment gives significantly better airway function and asthma control than delayed treatment and at tower maintenance doses.},
  author       = {Selroos, Olof and Lofroos, A B and Pietinalho, A and Riska, H},
  issn         = {1532-3064},
  keyword      = {budesonide,asthma,early treatment,delayed treatment,goals,treatment,Turbuhaler},
  language     = {eng},
  number       = {3},
  pages        = {254--262},
  publisher    = {Elsevier},
  series       = {Respiratory Medicine},
  title        = {Asthma control and steroid doses 5 years after early or delayed introduction of inhaled corticosteroids in asthma: a real-life study},
  url          = {http://dx.doi.org/10.1016/j.rmed.2003.10.007},
  volume       = {98},
  year         = {2004},
}