Effects of dexamethasone and B-agonist enantiomers on glucocorticoid receptor translocation

Abstract

frequently (daily by 26%, >2 days per week by 16%), among those reporting any recent use. Avoiding exertion (47%) and staying inside (34%) were common approaches to improve control of asthma symptoms. More than half (55%) of respondents believed that only the symptoms of asthma can be treated. CONCLUSIONS: Parents and children overestimate the child's asthma control and commonly restrict activities to control asthma symptoms. Further education by physicians on the management of asthma and benefits of controller therapy is needed. RATIONALE: Approximately 20% of asthmatics smoke regularly, and cigarette smoking has been reported to increase asthma morbidity. Data on the efficacy of ICS and LABA combination therapy in this population are limited. METHODS: We reviewed exacerbation rates and asthma control among never-smokers (NS), former smokers (FS) and current smokers (CS) in the GOAL 1 study. Asthma control and exacerbations were assessed according to predefined criteria 1 . RESULTS: Of the 3416 patients in the ITT population 843 in Stratum 1 (S1), 865 in S2 and 818 in S3 had never smoked. 149 (S1), 217 (S2), 252 (S3) were FS and 106 (S1), 81 (S2), 85 (S3) were CS. The mean annual exacerbation rate was highest in CS. In all smoking groups the exacerbation rates were lower with SFC treatment than with FP, with the difference most apparent among the CS and FS (CS 0.35, FS 0.23, NS 0.17 on FP vs CS 0.20, FS 0.14, NS 0.13 on SFC). Well-controlled asthma was achieved in more NS than CS and FS with both SFC and FP, and in all smoking groups was achieved in a higher proportion of patients on SFC than on FP alone. CONCLUSIONS: Cigarette smoking affects asthma control and the risk of exacerbations. SFC resulted in fewer exacerbations and a greater proportion of patients with well-controlled asthma than FP in current and former smokers.