Bronchial Hyper-responsiveness is Reduced by Antiasthmatics And self-monitoring appears to be related to increased lung function

To determine the efficacy of prophylactic antiasthmatic therapy, 24 atopic patients with moderate or severe bronchial hyper-responsiveness received aerosolised salbutamol [albuterol] 200.ug 4 times daily alone or in combination with ~ 1 other antiasthmatic for 1-2 years. Patients were randomised to a study group (n = 13) in which patients recorded airway function and symptom scores daily, or to a control group (11) who did not .

In the study group, airway function and symptom scores were used to guide changes in therapy. Doses of inhaled salbutamol and beclomethasone were doubled and short oral prednisolone courses instituted if a sustained or severe increase in symptoms was noted. Beclomethasone inhalation was reduced in patients who showed sustained symptomatic improvements.

Mean FEV 1 before drug administration changed from 77 (baseline) to 93% predicted (final measurement; p < 0.Q1) among study patients and from 88 to 87% predicted among controls. In the study group bronchial hyper-responsiveness (as measured by histamine inhalation tests; PD20 FEV d was

significantly reduced and variability of daily airway function decreased from 106% at baseline to 29%; this parameter was significantly correlated with PD20 FEV 1 at baseline and at study end. .

In the study group, 7 patients attempted to reduce therapy after attaining Improved bronchial hyper-responsiveness; reduction was successful in 4 patients who were followed up for 3 months, while.. . exacerbations occurred in 3. However, 2 of the latter underwent successful reduction after restabilisation for 1 month Baseline symptom scores improved in study patients more than in control patients

'This study shows that the severity of BHR [bronchial hyper-responsiveness] in subjects with severe asthma can be decreased with appropriate pharmacological therapy.' Bronchial hyper-responsiveness improved more in patients who monitored their lung function ; possibly this improved their compliance and thus ensured continuous prophylaxis . Woolcock AJ . Van K. Salome CM Clinical Allergy 18 165·176. Mar 1988 .... ,

10 INPHARMA- 4 June 1988 0156·2703/ 88/ 0604001010S01 .0010 © ADIS Press