BACKGROUND: Inhaled corticosteroids (ICS) provide short term benefits in asthma but the long term effects are still unknown. METHODS: 281 patients diagnosed with moderate to severe asthma in 1963-75 were re-examined in 1991-9. Information was collected on forced expiratory volume in 1 second (FEV(1)), bronchial hyperresponsiveness, atopy, smoking, use and dosage of oral and ICS. Patients were included in the analyses if they had at least three FEV(1) measurements during two consecutive years after the age of 30 and used ICS during follow up. RESULTS: Analyses were performed on 122 patients. During a median follow up period of 23 years, 71 men and 51 women had on average 37 and 40 individual FEV(1) measurements, respectively. Linear mixed effect models showed that men had a mean annual decline in FEV(1) of 20.6 ml/year less after ICS initiation than before (p = 0.011), and in women the decline in FEV(1) was 3.2 ml/year less (p = 0.73). In individuals with <5 pack years of smoking the decline in FEV(1) was 36.8 ml/year less after ICS institution in men (p = 0.0097) and 0.8 ml/year less in women (p = 0.94), the difference between the sexes being significant (p = 0.045). These effects were not observed in those with > or =5 pack years smoking. A higher daily dose of ICS was associated with a smaller decline in FEV(1) in men (p = 0.006), an effect not observed in women. CONCLUSION: Treatment with ICS in adult patients with moderate to severe asthma was associated with a reduction in the decline in FEV(1) over a 23 year follow up period in men who had smoked <5 pack years. This effect was dose dependent and was not present in women or in men with > or =5 pack years of smoking at follow up. The lack of effect of ICS on the decline in FEV(1) in women needs further study.
BACKGROUND: Inhaled corticosteroids (ICS) provide short term benefits in asthma but the long term effects are still unknown. METHODS: 281 patients diagnosed with moderate to severe asthma in 1963-75 were re-examined in 1991-9. Information was collected on forced expiratory volume in 1 second (FEV(1)), bronchial hyperresponsiveness, atopy, smoking, use and dosage of oral and ICS. Patients were included in the analyses if they had at least three FEV(1) measurements during two consecutive years after the age of 30 and used ICS during follow up. RESULTS: Analyses were performed on 122 patients. During a median follow up period of 23 years, 71 men and 51 women had on average 37 and 40 individual FEV(1) measurements, respectively. Linear mixed effect models showed that men had a mean annual decline in FEV(1) of 20.6 ml/year less after ICS initiation than before (p = 0.011), and in women the decline in FEV(1) was 3.2 ml/year less (p = 0.73). In individuals with <5 pack years of smoking the decline in FEV(1) was 36.8 ml/year less after ICS institution in men (p = 0.0097) and 0.8 ml/year less in women (p = 0.94), the difference between the sexes being significant (p = 0.045). These effects were not observed in those with > or =5 pack years smoking. A higher daily dose of ICS was associated with a smaller decline in FEV(1) in men (p = 0.006), an effect not observed in women. CONCLUSION: Treatment with ICS in adult patients with moderate to severe asthma was associated with a reduction in the decline in FEV(1) over a 23 year follow up period in men who had smoked <5 pack years. This effect was dose dependent and was not present in women or in men with > or =5 pack years of smoking at follow up. The lack of effect of ICS on the decline in FEV(1) in women needs further study.
Authors: Stanley Szefler; Scott Weiss; James Tonascia; N Franklin Adkinson; Bruce Bender; Reuben Cherniack; Michele Donithan; H William Kelly; Joseph Reisman; Gail G Shapiro; Alice L Sternberg; Robert Strunk; Virginia Taggart; Mark Van Natta; Robert Wise; Margaret Wu; Robert Zeiger Journal: N Engl J Med Date: 2000-10-12 Impact factor: 91.245
Authors: Alan L James; Lyle J Palmer; Elizabeth Kicic; Peta S Maxwell; Sharon E Lagan; Gerard F Ryan; A William Musk Journal: Am J Respir Crit Care Med Date: 2004-10-14 Impact factor: 21.405
Authors: L Di Giampaolo; E Cavallucci; M Braga; A Renzetti; C Schiavone; C Quecchia; C Petrarca; M Di Gioacchino Journal: Int Arch Occup Environ Health Date: 2011-06-04 Impact factor: 3.015
Authors: M D Lougheed; C Lemière; S D Dell; F M Ducharme; J Mark Fitzgerald; R Leigh; C Licskai; B H Rowe; D Bowie; A Becker; Louis-Philippe Boulet Journal: Can Respir J Date: 2010 Jan-Feb Impact factor: 2.409
Authors: Stephen T Holgate; Hasan S Arshad; Graham C Roberts; Peter H Howarth; Philipp Thurner; Donna E Davies Journal: Clin Sci (Lond) Date: 2009-12-23 Impact factor: 6.124
Authors: Barbro N Melgert; Timothy B Oriss; Zengbiao Qi; Barbara Dixon-McCarthy; Marie Geerlings; Machteld N Hylkema; Anuradha Ray Journal: Am J Respir Cell Mol Biol Date: 2009-07-02 Impact factor: 6.914
Authors: Michael J McGeachie; Katherine P Yates; Xiaobo Zhou; Feng Guo; Alice L Sternberg; Mark L Van Natta; Robert A Wise; Stanley J Szefler; Sunita Sharma; Alvin T Kho; Michael H Cho; Damien C Croteau-Chonka; Peter J Castaldi; Gaurav Jain; Amartya Sanyal; Ye Zhan; Bryan R Lajoie; Job Dekker; John Stamatoyannopoulos; Ronina A Covar; Robert S Zeiger; N Franklin Adkinson; Paul V Williams; H William Kelly; Hartmut Grasemann; Judith M Vonk; Gerard H Koppelman; Dirkje S Postma; Benjamin A Raby; Isaac Houston; Quan Lu; Anne L Fuhlbrigge; Kelan G Tantisira; Edwin K Silverman; James Tonascia; Robert C Strunk; Scott T Weiss Journal: Am J Respir Crit Care Med Date: 2016-12-15 Impact factor: 21.405
Authors: Oren Shavit; Arlene Swern; Qian Dong; Kathleen Newcomb; Vasilisa Sazonov Kocevar; Stephanie D Taylor Journal: Qual Life Res Date: 2007-10-05 Impact factor: 4.147