מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Use of inhaled corticosteroids in combination with long-acting beta-2-agonists appears to make asthmatics more aware of bronchoconstriction, according to Dutch researchers.
Dr. Ingrid D. Bijl-Hofland of the University of Nijmegen and colleagues note that as well as possibly leading to undertreatment, "poor perception of asthma symptoms may be a major underlying cause of fatal or near-fatal asthma attacks."
To investigate what influence medication might have on such perception, the researchers studied 64 adult asthmatics. After a wash-out period, during which the subjects stopped all pulmonary medication, they were randomized to 12 weeks of treatment with the short-acting beta-2-agonist salbutamol (albuterol), the long-acting beta-2-agonist formoterol, or placebo.
At baseline, and at 4-week intervals, they underwent bronchial challenge with histamine and their degree of respiratory discomfort due to the ensuing bronchoconstriction was assessed, the researchers explain in the September 1st issue of the American Journal of Respiratory and Critical Care Medicine. One year later, the whole process was repeated. However, in addition to the earlier treatment, all patients received inhaled corticosteroids.
Analysis of challenge results showed that, compared with the first year, the combination of long-acting acting beta-2-agonists and inhaled corticosteroids was the only treatment that improved the sensitivity of perception of a 20% drop in lung function (FEV1).
Given this finding, the researchers conclude that apart from the known clinical benefits, "the positive effects on perception of airway obstruction might be another argument for using this combination of drugs."
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