Extrafine compared to non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma

Cox, Claire A.; Boudewijn, Ilse M.; Vroegop, Sebastiaan J.; Schokker, Siebrig; Lexmond, Anne J.; Frijlink, Henderik W.; Hagedoorn, Paul; Vonk, Judith M.; Farenhorst, Martijn P.; Hacken, Nick H. T. ten; Kerstjens, Huib A. M.; Postma, Dirkje S.; Berge, Maarten van den

doi:10.1016/j.rmed.2017.07.005

Cited by 10 publications

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“…For this study 77 subjects were screened. However, 18 subjects were excluded as they were unable to perform spirometry or a provocation test adequately ( n = 5), complete the medication washout period ( n = 8), had chronic non-asthmatic respiratory diseases ( n = 2), or had other unstable non-respiratory diseases ( n = 3) [22]. A total of 59 subjects underwent both provocation tests of which 36 performed a MBNW test.…”

Section: Resultsmentioning

confidence: 99%

“…This study was performed with baseline data from the previously published OLiVIA study (clinical trial number: NCT01741285, www.clinicaltrials.gov) [22]. Included subjects were asthmatics (doctor’s diagnosis), current or ex-smokers (> 5 pack years), aged between 18 and 65 years, and all had a preserved lung function (FEV 1 > 50%predicted and > 1.2 L).…”

Section: Methodsmentioning

confidence: 99%

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Associations of AMP and adenosine induced dyspnea sensation to large and small airways dysfunction in asthma

et al. 2019

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BackgroundBronchial provocation is often used to confirm asthma. Dyspnea sensation, however, associates poorly with the evoked drop in FEV1. Provocation tests only use the large airways parameter FEV1, although dyspnea is associated with both large- and small airways dysfunction. Aim of this study was to explore if adenosine 5′-monophosphate (AMP) and adenosine evoke an equal dyspnea sensation and if dyspnea associates better with large or small airways dysfunction.MethodsWe targeted large airways with AMP and small airways with dry powder adenosine in 59 asthmatic (ex)-smokers with ≥5 packyears, 14 ± 7 days apart. All subjects performed spirometry, impulse oscillometry (IOS), and Borg dyspnea score. In 36 subjects multiple breath nitrogen washout (MBNW) was additionally performed. We analyzed the association of the change (Δ) in Borg score with the change in large and small airways parameters, using univariate and multivariate linear regression analyses. MBNW was analyzed separately.ResultsProvocation with AMP and adenosine evoked similar levels of dyspnea. ΔFEV1 was not significantly associated with ΔBorg after either AMP or adenosine provocation, in both univariate and multivariate analyses. In multivariate linear regression, a decrease in FEF25–75 during adenosine provocation was independently associated with an increase in Borg. In the multivariate analyses for AMP provocation, no significant associations were found between ΔBorg and any large or small airways parameters.ConclusionAMP and adenosine induce equally severe dyspnea sensations. Our results suggest that dyspnea induced with dry powder adenosine is related to small airways involvement, while neither large nor small airways dysfunction was associated with AMP-induced dyspnea.Trail registrationNCT01741285 at www.clinicaltrials.gov, first registered Dec 4th, 2012.Electronic supplementary materialThe online version of this article (10.1186/s12890-019-0783-0) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Associations of AMP and adenosine induced dyspnea sensation to large and small airways dysfunction in asthma

et al. 2019

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“…We hypothesized that smokers and ex-smokers with asthma would benefit more from extrafine than non-extrafine particle ICS. However, our OLiVIA-study showed that extrafine and non-extrafine particle ICS were equally effective in improving small airways function in current and ex-smokers with asthma [5]. This outcome might be ascribed to the fact that the presence of SAD was not an inclusion criterion in our study.…”

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confidence: 80%

“…(Clenil) and non-extrafine HFA-fluticasone 250 μg b.i.d. (Flixotide) [5]. The primary outcome was the change in airway hyperresponsiveness (AHR) to small particle adenosine, expressed as the provocative dose of adenosine causing a 20% drop in FEV 1 (forced expiratory volume at 1 s) from baseline to post-treatment (ΔPD 20 ).…”

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confidence: 99%

Predictors of clinical response to extrafine and non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma

et al. 2018

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We performed a post-hoc analysis of the OLiVIA-study investigating whether current and ex-smoking asthmatics with small airways dysfunction (SAD) show a better response in airway hyperresponsiveness (AHR) to small particle adenosine after treatment with extrafine compared to non-extrafine particle inhaled corticosteroids (ICS), and to investigate which clinical parameters predict a favorable response to both treatments. We show that smoking and ex-smoking asthmatics with and without SAD have a similar treatment response with either extrafine or non-extrafine particle ICS. We also found that lower blood neutrophils are associated with a smaller ICS-response in smokers and ex-smokers with asthma, independent from the level of blood eosinophils.Electronic supplementary materialThe online version of this article (10.1186/s12931-018-0961-2) contains supplementary material, which is available to authorized users.

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“…Data were collected from participants of two asthma studies on ICS treatment: OLiVIA (n = 39, 2‐week HFA‐beclomethasone 200 µg b.i.d . and NZRHS (n = 28, 12‐week budesonide 400 µg b.i.d).…”

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Nasal gene expression changes with inhaled corticosteroid treatment in asthma

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et al. 2019

Allergy

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Extrafine compared to non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma

Abstract: Similar effectiveness in improving small airways function was found for extrafine and non-extrafine particle ICS treatment for asthmatic smokers and ex-smokers.

Cited by 10 publications

References 41 publications

Associations of AMP and adenosine induced dyspnea sensation to large and small airways dysfunction in asthma

Associations of AMP and adenosine induced dyspnea sensation to large and small airways dysfunction in asthma

Predictors of clinical response to extrafine and non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma

Nasal gene expression changes with inhaled corticosteroid treatment in asthma

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