BACKGROUND: Inhaled formulations using extrafine particles of long-acting β2-agonists and corticosteroids were developed to optimize asthma treatment. Findings that these combinations reach and treat smaller airways more effectively are predominantly based on general non-specific outcomes with little information on regional characteristics. OBJECTIVES: This study aims to assess long-term effects of extrafine beclomethasone/formoterol on small airways of asthmatic patients using novel functional imaging methods. METHODS: Twenty-four stable asthma patients were subdivided into three groups (steroid naive, n = 7; partially controlled, n = 6; well controlled, n = 11). Current treatment was switched to a fixed combination of extrafine beclomethasone/formoterol (Foster®; Chiesi Pharmaceuticals, Parma, Italy). Patients underwent lung function evaluation and thorax high-resolution computerized tomography (HRCT) scan. Local airway resistance was obtained from computational fluid dynamics (CFD). RESULTS: After 6 months, the entire population showed improvement in pre-bronchodilation imaging parameters, including small airway volume (p = 0.0007), resistance (p = 0.011), and asthma control score (p = 0.016). Changes in small airway volume correlated with changes in asthma control score (p = 0.004). Forced expiratory volume in 1 s (p = 0.044) and exhaled nitric oxide (p = 0.040) also improved. Functional imaging provided more detail and clinical relevance compared to lung function tests, especially in the well-controlled group where only functional imaging parameters showed significant improvement, while the correlation with asthma control score remained. CONCLUSIONS: Extrafine beclomethasone/formoterol results in a significant reduction of small airway obstruction, detectable by functional imaging (HRCT/CFD). Changes in imaging parameters correlated significantly with clinically relevant improvements. This indicates that functional imaging is a useful tool for sensitive assessment of changes in the respiratory system after asthma treatment.
BACKGROUND: Inhaled formulations using extrafine particles of long-acting β2-agonists and corticosteroids were developed to optimize asthma treatment. Findings that these combinations reach and treat smaller airways more effectively are predominantly based on general non-specific outcomes with little information on regional characteristics. OBJECTIVES: This study aims to assess long-term effects of extrafine beclomethasone/formoterol on small airways of asthmatic patients using novel functional imaging methods. METHODS: Twenty-four stable asthmapatients were subdivided into three groups (steroid naive, n = 7; partially controlled, n = 6; well controlled, n = 11). Current treatment was switched to a fixed combination of extrafine beclomethasone/formoterol (Foster®; Chiesi Pharmaceuticals, Parma, Italy). Patients underwent lung function evaluation and thorax high-resolution computerized tomography (HRCT) scan. Local airway resistance was obtained from computational fluid dynamics (CFD). RESULTS: After 6 months, the entire population showed improvement in pre-bronchodilation imaging parameters, including small airway volume (p = 0.0007), resistance (p = 0.011), and asthma control score (p = 0.016). Changes in small airway volume correlated with changes in asthma control score (p = 0.004). Forced expiratory volume in 1 s (p = 0.044) and exhaled nitric oxide (p = 0.040) also improved. Functional imaging provided more detail and clinical relevance compared to lung function tests, especially in the well-controlled group where only functional imaging parameters showed significant improvement, while the correlation with asthma control score remained. CONCLUSIONS: Extrafine beclomethasone/formoterol results in a significant reduction of small airway obstruction, detectable by functional imaging (HRCT/CFD). Changes in imaging parameters correlated significantly with clinically relevant improvements. This indicates that functional imaging is a useful tool for sensitive assessment of changes in the respiratory system after asthma treatment.
Authors: P Worth Longest; Karl Bass; Rabijit Dutta; Vijaya Rani; Morgan L Thomas; Ahmad El-Achwah; Michael Hindle Journal: Expert Opin Drug Deliv Date: 2018-12-10 Impact factor: 6.648
Authors: Maged Awadalla; Shinjiro Miyawaki; Mahmoud H Abou Alaiwa; Ryan J Adam; Drake C Bouzek; Andrew S Michalski; Matthew K Fuld; Karen J Reynolds; Eric A Hoffman; Ching-Long Lin; David A Stoltz Journal: Ann Biomed Eng Date: 2013-12-06 Impact factor: 3.934
Authors: Aukje C Bos; Cedric van Holsbeke; Jan W de Backer; Mireille van Westreenen; Hettie M Janssens; Wim G Vos; Harm A W M Tiddens Journal: PLoS One Date: 2015-03-03 Impact factor: 3.240
Authors: F Braido; N Scichilone; F Lavorini; O S Usmani; L Dubuske; L P Boulet; R Mosges; C Nunes; M Sanchez-Borges; I J Ansotegui; M Ebisawa; F Levi-Schaffer; L J Rosenwasser; J Bousquet; T Zuberbier; G Walter Canonica; A Cruz; A Yanez; A Yorgancioglu; D Deleanu; G Rodrigo; J Berstein; K Ohta; P Vichyanond; R Pawankar; S N Gonzalez-Diaz; S Nakajima; T Slavyanskaya; A Fink-Wagner; C Baez Loyola; D Ryan; G Passalacqua; J Celedon; J C Ivancevich; K Dobashi; M Zernotti; M Akdis; S Benjaponpitak; S Bonini; W Burks; L Caraballo; Z Awad El-Sayed; S Fineman; P Greenberger; E Hossny; J A Ortega-Martell; H Saito; M Tang; L Zhang Journal: World Allergy Organ J Date: 2016-10-28 Impact factor: 4.084
Authors: F Braido; N Scichilone; F Lavorini; O S Usmani; L Dubuske; L P Boulet; R Mosges; C Nunes; M Sánchez-Borges; I J Ansotegui; M Ebisawa; F Levi-Schaffer; L J Rosenwasser; J Bousquet; T Zuberbier; G Walter Canonica Journal: Asthma Res Pract Date: 2016-10-28
Authors: Maarten van den Berge; Jan De Backer; Cedric Van Holsbeke; Wilfried De Backer; Roopa Trivedi; Martin Jenkins; Paul Dorinsky; Magnus Aurivillius Journal: Respir Res Date: 2021-07-01