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Article Dans Une Revue Pediatric Pulmonology Année : 2010

Pilot study: The effect of reducing treatment on exercise induced bronchoconstriction.

Elin T.G. Kersten
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Jean Driessen
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Janneke C. van Leeuwen
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Bj Thio
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Résumé

Rationale: Asthma therapy should be stepped up or stepped down in response to changes in asthma control. However, there is little evidence available on the optimal timing, sequence and degree of medication reductions. In this study we analyzed clinically stable asthmatic children who underwent a medication reduction from a combination preparation consisting of an inhaled corticosteroid (ICS) and long acting beta2-agonists (LABA) to monotherapy with the same dose of the ICS. We hypothesized that the extent of exercise induced bronchoconstriction (EIB) would not increase after the cessation of the LABA. Methods: 19 children, aged 8-16 years, with clinically stable asthma, receiving LABA/ICS combination therapy, were analyzed in this open-label pilot study. Children performed an exercise challenge at baseline and 3 weeks after the medication reduction. Best values of spirometric measurements of the forced expiratory volume in 1 second (FEV1) were used for statistical calculations. Results: Maximum percent fall in FEV1 was significantly lower after 3 weeks of ICS monotherapy (p = 0.03). 8/19 children had a ≥ 15% fall in FEV1 after exercise at the initial exercise challenge. In this subgroup, maximum percent fall in FEV1 after the medication reduction was significantly lower (p < 0.01), and in 6 children it decreased to < 15%, indicating they no longer had EIB. Conclusion: In clinically stable asthmatic children on LABA/ICS combination therapy, the cessation of the LABA can reduce and in most cases abolish EIB.

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Dates et versions

hal-00552428 , version 1 (06-01-2011)

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Elin T.G. Kersten, Jean Driessen, Janneke C. van Leeuwen, Bj Thio. Pilot study: The effect of reducing treatment on exercise induced bronchoconstriction.. Pediatric Pulmonology, 2010, 45 (9), pp.927. ⟨10.1002/ppul.21278⟩. ⟨hal-00552428⟩

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