An experimental asthma exacerbation following discontinuation of inhaled corticosteroids treatment in patients with controlled asthma / 천식및알레르기

ABSTRACT

BACKGROUND: It has been recognized that cessation of treatment with inhaled corticosteroids evokes a recurrence of symptoms in most asthmatics within a month. OBJECTIVE: To examine whether a useful model of asthma for studies on effects of new antiasthmatic drugs can be induced by discontinuation of inhaled corticosteroids treatment. METHOD: Twenty five patients with controlled asthma on inhaled corticosteroids were enrolled in this study. Spirometric measurements were performed before and 2 weeks after cessation of treatment with inhaled budesonide. Peak expiratory flow rates(PEFR), asthma symptom scores, and short-acting inhaled beta2 agonist requirements were checked during 2-week period before and during 2-week period after the cessation of inhaled budesonide. RESULTS: Discontinuation of treatment with inhaled budesonide resulted in significant falls in FEV1, and morning and evening PEFRs, and significant increase in diurnal variability of PEFR (40% of patients showed diurnal variability of > or = 20%). Their symptom scores and the days required for salbutamol use were also significantly increased. However, the mean fall in FEV1 was 6.9% and the maximum fall 29%, and a significant fall (> or =15%) occurred in only 29% of patients. CONCLUSION: These findings demonstrate that asthma exacerbation can be safely induced by discontinuation of treatment with inhaled corticosteroids in controlled asthmatics, suggesting that this experimental model of mild asthma exacerbation can be used for studying the effects of new antiasthmatic drugs.