Literature DB >> 12602665

Dose response of inhaled corticosteroids on bronchial hyperresponsiveness: a meta-analysis.

Graeme P Currie1, Stephen J Fowler, Brian J Lipworth.   

Abstract

BACKGROUND: There is a relatively steep dose-response curve for effects of inhaled corticosteroids on conventional airway markers of asthmatic disease control.
OBJECTIVE: We sought to determine whether a dose-response effect exists for bronchial hyperresponsiveness.
METHODS: A meta-analysis of placebo-controlled trials in asthmatic patients was performed using a computerized systematic review of databases. Doubling dose/dilution protection of inhaled corticosteroid was compared with placebo. Studies which used direct (methacholine and histamine) and indirect (adenosine monophosphate) bronchial challenge stimuli were eligible for inclusion.
RESULTS: Twenty-five studies fulfilled eligibility criteria (963 patients). Values for doubling dose/dilution protection categorized by low/medium dose (< 1,000 microg) and high dose (> or = 1,000 microg) of inhaled corticosteroid amounted to a 1.25 (95% confidence interval 1.08 to 1.42) and 2.16 (95% confidence interval 1.88 to 2.44) shift, respectively.
CONCLUSIONS: High doses of inhaled corticosteroids conferred greater improvements in bronchial hyperresponsiveness than low doses.

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Year:  2003        PMID: 12602665     DOI: 10.1016/S1081-1206(10)62140-0

Source DB:  PubMed          Journal:  Ann Allergy Asthma Immunol        ISSN: 1081-1206            Impact factor:   6.347


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