Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1990 Feb;45(2):118–121. doi: 10.1136/thx.45.2.118

Time course of response to oral and inhaled corticosteroids in non-asthmatic chronic airflow obstruction.

D C Weir 1, A S Robertson 1, R I Gove 1, P S Burge 1
PMCID: PMC462321  PMID: 2180106

Abstract

One hundred and twenty one patients considered on clinical grounds to have non-asthmatic chronic airflow obstruction completed a double blind, crossover trial comparing oral prednisolone 40 mg per day with inhaled beclomethasone dipropionate 500 micrograms thrice daily, each given for 14 days, with a 14 day washout period between treatments. The time course of response was analysed for the 57 occasions where there was a significant increase in mean daily peak expiratory flow (PEF) over the treatment period. Mean daily PEF was still rising at day 14 on 12 occasions. After withdrawal of treatment mean daily PEF remained above pretreatments levels for more than two weeks in half the responses analysed. The peak response occurred earlier with inhaled beclomethasone (median 9.5 (range 3-14) days) than with oral prednisolone (median 12 (range 1-14) days), though both treatments produced a response that was sustained for a similar period. The results suggest that a trial of treatment with corticosteroids in this group of patients should last more than 14 days, and that in a study with a crossover design the washout period should be longer than two weeks.

Full text

PDF
118

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Clark T. J. Effect of beclomethasone dipropionate delivered by aerosol in patients with asthma. Lancet. 1972 Jun 24;1(7765):1361–1364. doi: 10.1016/s0140-6736(72)91094-x. [DOI] [PubMed] [Google Scholar]
  2. Eliasson O., Hoffman J., Trueb D., Frederick D., McCormick J. R. Corticosteroids in COPD. A clinical trial and reassessment of the literature. Chest. 1986 Apr;89(4):484–490. doi: 10.1378/chest.89.4.484. [DOI] [PubMed] [Google Scholar]
  3. Harding S. M., Freedman S. A comparison of oral and inhaled steroids in patients with chronic airways obstruction: features determining response. Thorax. 1978 Apr;33(2):214–218. doi: 10.1136/thx.33.2.214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Lam W. K., So S. Y., Yu D. Y. Response to oral corticosteroids in chronic airflow obstruction. Br J Dis Chest. 1983 Apr;77(2):189–198. doi: 10.1016/0007-0971(83)90027-x. [DOI] [PubMed] [Google Scholar]
  5. Mendella L. A., Manfreda J., Warren C. P., Anthonisen N. R. Steroid response in stable chronic obstructive pulmonary disease. Ann Intern Med. 1982 Jan;96(1):17–21. doi: 10.7326/0003-4819-96-1-17. [DOI] [PubMed] [Google Scholar]
  6. Mintz S., Broder I., Davies G., Leznoff A., Rostum H., Silverman F. A double-blind cross-over study of beclomethasone dipropionate in asthmatic patients with and without chronic bronchitis. Postgrad Med J. 1975;51 (Suppl 4):76–79. [PubMed] [Google Scholar]
  7. Mitchell D. M., Gildeh P., Dimond A. H., Collins J. V. Value of serial peak expiratory flow measurements in assessing treatment response in chronic airflow limitation. Thorax. 1986 Aug;41(8):606–610. doi: 10.1136/thx.41.8.606. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Mitchell D. M., Gildeh P., Rehahn M., Dimond A. H., Collins J. V. Effects of prednisolone in chronic airflow limitation. Lancet. 1984 Jul 28;2(8396):193–196. doi: 10.1016/s0140-6736(84)90481-1. [DOI] [PubMed] [Google Scholar]
  9. Sahn S. A. Corticosteroids in chronic bronchitis and pulmonary emphysema. Chest. 1978 Mar;73(3):389–396. doi: 10.1378/chest.73.3.389. [DOI] [PubMed] [Google Scholar]
  10. Salmeron S., Guerin J. C., Godard P., Renon D., Henry-Amar M., Duroux P., Taytard A. High doses of inhaled corticosteroids in unstable chronic asthma. A multicenter, double-blind, placebo-controlled study. Am Rev Respir Dis. 1989 Jul;140(1):167–171. doi: 10.1164/ajrccm/140.1.167. [DOI] [PubMed] [Google Scholar]
  11. Stokes T. C., Shaylor J. M., O'Reilly J. F., Harrison B. D. Assessment of steroid responsiveness in patients with chronic airflow obstruction. Lancet. 1982 Aug 14;2(8294):345–348. doi: 10.1016/s0140-6736(82)90545-1. [DOI] [PubMed] [Google Scholar]
  12. Webb J., Clark T. J., Chilvers C. Time course of response to prednisolone in chronic airflow obstruction. Thorax. 1981 Jan;36(1):18–21. doi: 10.1136/thx.36.1.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Webb J., Clark T. J. Recovery of plasma corticotrophin and cortisol levels after three-week course of prednisolone. Thorax. 1981 Jan;36(1):22–24. doi: 10.1136/thx.36.1.22. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES