Dexamethasone-isonicotinate aerosol in the long-term treatment of steroid-dependent asthmatic children.

Dexamethasone-isonicotinate aerosol (DIA) was administered to twenty-nine steroid-dependent children with chronic perennial asthma, in an open trial during one year. An attempt was made to withdraw systemic corticosteroid therapy. As judged by clinical results, inhaled dexamethasone-isonicotinate controlled the asthma quite as well as did previous therapy. Oral corticosteroids were withdrawn in 27 patients, and the dosage considerably reduced in another two. Cushingoid features subsided. There was a statistically significant improvement in most pulmonary function parameters (airway obstruction and lung hyperinflation were reduced towards normal). Reduction of systemic steroid dosage resulted in the appearance of previously suppressed manifestations such as hay fever, eczema, and nasal polyps. There was no increased tendency to the occurrence of respiratory tract infection; routine examination showed Candida albicans in about 37% cultures.

Dexamethasone isonicotinate aerosol therapy in patients with chronic bronchial asthma.

Dexamethasone isonicotinate aerosols were used for the management of 106 patients (33 men, 73 women) with bronchial asthma (mean age 32.7 years); 62 of the patients were steroid-dependent (maintenance dose 1 to 25 mg prednisone/day for 0.5 to 11 years) at the start of the study. A diary of symptoms (including consumption of antiasthmatic drugs) was kept; physical examination and measurement of pulmonary function (peak flow rate, forced expiratory volume in one second) were performed during a one-to-four week control period, as well as at various intervals (up to 14 months) after the start of corticosteroid aerosol therapy. Clinical subjective and objective improvement was accompanied by a significant increase in ventilatory function indices (e.g. the FEV1.0 rose from a control average of 55.5% of predicted to 72% after 4 weeks and 85% after 12 months). The antiasthmatic drug consumption decreased markedly. Administration of systemic steroids could be withdrawn in 49 of the 62 steroid-dependent patients (79%); in the remaining 13 the dose was only lowered. The side-effects were minor (hoarseness of the voice, oropharyngeal candidosis), and limited to a few cases. It is concluded that bronchial asthma can be successfully controlled in four fifths of the patients by very low doses of dexamethasone isonicotinate aerosols, with practically no systemic effects.

Prevalence of respiratory symptoms in towns with different air pollution.

An epidemiologic study was carried out for the estimation of air pollution as a risk factor for chronic obstructive lung disease. The whole male population aged 40 to 60 years was investigated in a polluted and a non-polluted control town. The subjects with occupational exposure to dusts, gases and irritant vapours were discarded from the study. The prevalence of respiratory symptoms and of chronic bronchitis in the polluted town was twice that in the control (non-polluted) one. These results are discussed in the light of some previous investigations of the authors and of the available data in the literature.