Bronchodilator response as a hallmark of uncontrolled asthma: a randomised clinical trial

Bronchodilator response as a hallmark of uncontrolled asthma: a randomised clinical trial

Author Godoy Fernandes, Ana Luisa Autor UNIFESP Google Scholar
Amorim, Maria Marta Autor UNIFESP Google Scholar
Caetano, Lilian Ballini Autor UNIFESP Google Scholar
Dracoulakis, Samir Autor UNIFESP Google Scholar
Ramalho Araruna, Alexandre Augusto Autor UNIFESP Google Scholar
Faresin, Sonia Maria Autor UNIFESP Google Scholar
Santoro, Ilka Lopes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Introduction: the goal of this study is to determine whether bronchodilator (BD) response can be used as a reliable measure of asthma control by analyzing the effects of a short course of oral corticosteroids (OC) or placebo (P) on spirometry, sputum cytology and BD response in controlled asthma patients scoring less than 1.5 on the ACQ5. Methods: Seventy patients with moderate to severe asthma who were undergoing combination therapy and were considered to be controlled based on ACQ5 scores, but who exhibited persistent positive BD response, were randomly assigned to two groups, one receiving OC and the other P. Patients were evaluated before and after 2 weeks of treatment. Intervention response (comparison of FEV1 before and after OC or P treatment) was used as a measure of intervention efficacy, with values equal to or greater than 200 mL considered positive. Results: Patients who received OC showed significant improvement in FEV1, and no longer exhibited a positive BD response. Those in the P group showed no change. in addition, sputum eosinophil counts significantly decreased in the OC group. Conclusions: BD response can be used as a reliable measure of asthma control. This study suggests that ACQ5 scores alone are not sufficient to fully assess asthma control, and that BD response should be included as an essential measurement in any algorithm of asthma control evaluation.
Keywords Control/management
management/control
morbidity and mortality
prevention
therapy
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 2005/04714-1
Date 2014-05-01
Published in Journal of Asthma. New York: Informa Healthcare, v. 51, n. 4, p. 405-410, 2014.
ISSN 0277-0903 (Sherpa/Romeo, impact factor)
Publisher Informa Healthcare
Extent 405-410
Origin http://dx.doi.org/10.3109/02770903.2013.878845
Access rights Closed access
Type Article
Web of Science ID WOS:000334739000011
URI http://repositorio.unifesp.br/handle/11600/37760

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