Withdrawal of inhaled steroids in children with non-cystic fibrosis bronchiectasis

Abstract

In this study, 12 week-withdrawal of inhaled steroid treatment resulted in a significant increase in bronchial hyperreactivity and decrease in neutrophil apoptosis, but no change in sputum inflammatory markers in children with non-CF bronchiectasis was observed.

Evaluation of children with cystic fibrosis by impulse oscillometry when stable and at exacerbation

“…The R (raw as well as percent predicted) values during exacerbation were higher at all frequencies examined (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) Hz) than the 1st, 2nd, and 3rd measurement values during the stable period. After the treatment of the acute exacerbation, R values (raw as well as percent predicted) at all frequencies decreased significantly (Tables 4 and 5).…”

“…Symptoms were separately scored with presence and increasing intensity, with a possible total score of 0 if there are no symptoms and 15 if patients have severe symptoms and green sputum. 14 Patients aged >6 years performed both spirometry and IOS while patients aged 6 years only performed IOS. In all patients who could comply with spirometry, spirometry was performed concurrently with IOS three times at 3-month intervals.…”

Evaluation of children with cystic fibrosis by impulse oscillometry when stable and at exacerbation

“…The R (raw as well as percent predicted) values during exacerbation were higher at all frequencies examined (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) Hz) than the 1st, 2nd, and 3rd measurement values during the stable period. After the treatment of the acute exacerbation, R values (raw as well as percent predicted) at all frequencies decreased significantly (Tables 4 and 5).…”

“…Symptoms were separately scored with presence and increasing intensity, with a possible total score of 0 if there are no symptoms and 15 if patients have severe symptoms and green sputum. 14 Patients aged >6 years performed both spirometry and IOS while patients aged 6 years only performed IOS. In all patients who could comply with spirometry, spirometry was performed concurrently with IOS three times at 3-month intervals.…”

Management of bronchiectasis

“…HO et al [37] showed an improvement in a subgroup of patients with P. aeruginosa infection. Withdrawal of ICS after a 12-week course produced increased bronchial hyperreactivity and decreased neutrophil apoptosis but no other changes [38].…”

Bronchiectasis: Treatment decisions for pulmonary exacerbations and their prevention

“…64 However, a small study in children looked at withdrawing inhaled corticosteroids over 12 weeks resulting in increased bronchial hyper-reactivity and a decrease in neutrophil apoptosis but no change in sputum inflammatory markers. 65 In adults, inhaled corticosteroids did improve HRQoL and reduce symptoms in those in 'steady-state' bronchiectasis. 66 The appropriate use of steroids in bronchiectasis is complicated by the overlap of COPD and asthma in a significant number of patients.…”

Evaluation of children with cystic fibrosis by impulse oscillometry when stable and at exacerbation

“…The R (raw as well as percent predicted) values during exacerbation were higher at all frequencies examined (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) Hz) than the 1st, 2nd, and 3rd measurement values during the stable period. After the treatment of the acute exacerbation, R values (raw as well as percent predicted) at all frequencies decreased significantly (Tables 4 and 5).…”

“…Symptoms were separately scored with presence and increasing intensity, with a possible total score of 0 if there are no symptoms and 15 if patients have severe symptoms and green sputum. 14 Patients aged >6 years performed both spirometry and IOS while patients aged 6 years only performed IOS. In all patients who could comply with spirometry, spirometry was performed concurrently with IOS three times at 3-month intervals.…”

Management of bronchiectasis

“…HO et al [37] showed an improvement in a subgroup of patients with P. aeruginosa infection. Withdrawal of ICS after a 12-week course produced increased bronchial hyperreactivity and decreased neutrophil apoptosis but no other changes [38].…”

Bronchiectasis: Treatment decisions for pulmonary exacerbations and their prevention

“…64 However, a small study in children looked at withdrawing inhaled corticosteroids over 12 weeks resulting in increased bronchial hyper-reactivity and a decrease in neutrophil apoptosis but no change in sputum inflammatory markers. 65 In adults, inhaled corticosteroids did improve HRQoL and reduce symptoms in those in 'steady-state' bronchiectasis. 66 The appropriate use of steroids in bronchiectasis is complicated by the overlap of COPD and asthma in a significant number of patients.…”

Evaluation of children with cystic fibrosis by impulse oscillometry when stable and at exacerbation

“…The R (raw as well as percent predicted) values during exacerbation were higher at all frequencies examined (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) Hz) than the 1st, 2nd, and 3rd measurement values during the stable period. After the treatment of the acute exacerbation, R values (raw as well as percent predicted) at all frequencies decreased significantly (Tables 4 and 5).…”

“…Symptoms were separately scored with presence and increasing intensity, with a possible total score of 0 if there are no symptoms and 15 if patients have severe symptoms and green sputum. 14 Patients aged >6 years performed both spirometry and IOS while patients aged 6 years only performed IOS. In all patients who could comply with spirometry, spirometry was performed concurrently with IOS three times at 3-month intervals.…”

Management of bronchiectasis

“…HO et al [37] showed an improvement in a subgroup of patients with P. aeruginosa infection. Withdrawal of ICS after a 12-week course produced increased bronchial hyperreactivity and decreased neutrophil apoptosis but no other changes [38].…”

Bronchiectasis: Treatment decisions for pulmonary exacerbations and their prevention

“…64 However, a small study in children looked at withdrawing inhaled corticosteroids over 12 weeks resulting in increased bronchial hyper-reactivity and a decrease in neutrophil apoptosis but no change in sputum inflammatory markers. 65 In adults, inhaled corticosteroids did improve HRQoL and reduce symptoms in those in 'steady-state' bronchiectasis. 66 The appropriate use of steroids in bronchiectasis is complicated by the overlap of COPD and asthma in a significant number of patients.…”