Pilot study to assess the effect of inhaled corticosteroids on lung function in patients with cystic fibrosis☆,☆☆,★
Section snippets
METHODS
In our retrospective analysis of ICS, the mean FEV1 was 41% (SD = 14%) of the predicted values, and the magnitude of improvement achieved during the study period of 34.5 ± 12.5 days was 12.4%.5 To demonstrate the same amount of improvement in FEV1 on a significance level of 5%, we had to enroll 17 patients in each arm of the study; 25 patients were required to reach a significance level of 2%. Fifty patients admitted to our rehabilitation center in Davos, Switzerland, were informed about the
RESULTS
Characteristics of both study groups—such as age, severity of the disease as shown by Shwachman score6 or by total serum concentration of IgG,9 or atopic and infectious status (data not shown)—were not significantly different between the groups (p >0.05). The same applies to bacterial colonization and antibiotic treatment regimens (data not shown).
Lung function test results on entry are summarized in the Table. There was no significant difference in any measurement between the groups (p >0.05).
DISCUSSION
These preliminary data from a controlled study of ICS in the treatment of patients with CF show that, for a limited time, topically administered steroids significantly improved TGV and CO diffusion. The improvement of bronchial obstruction and pulmonary hyperinflation was accompanied by significantly better CO diffusion, suggesting a better peripheral ventilation/perfusion ratio.
Our study has limitations, mainly the short duration of therapy, the lack of standardization of other therapy, the
References (12)
- et al.
A multicenter study of alternate-day prednisone therapy in patients with cystic fibrosis
J Pediatr
(1995) - et al.
Progression of cystic fibrosis lung disease as a function of serum immunoglobulin G levels: a 5-year longitudinal study
J Pediatr
(1984) - et al.
Alternate-day prednisone reduces morbidity and improves pulmonary function in cystic fibrosis
Lancet
(1981) - et al.
Risks of alternate-day prednisone in patients with cystic fibrosis
Pediatrics
(1991) - et al.
Endocrine and lung function in asthmatic children on inhaled corticosteroids
Am J Respir Crit Care Med
(1994) - et al.
Effect of inhaled corticosteroids on lung function in cystic fibrosis patients [Abstract]
Eur Respir J
(1993)
Cited by (84)
A specialized method of sputum collection and processing for therapeutic interventions in cystic fibrosis
2019, Journal of Cystic FibrosisCitation Excerpt :Furthermore, sputum biomarkers have been used in the assessment of anti-inflammatory therapeutics in CF. However, many of these studies did not achieve significant changes in sputum for inflammatory endpoints including NE activity [26–45], despite significant effects in similar studies using BAL [20, 22, 46–48]. Indeed, many clinically relevant trials assessing potential anti-inflammatory therapies and inflammatory therapeutic targets in CF have opted not to use sputum [49–61]. Sputum data have also been absent from large-scale studies involving CFTR modulators [62–65].
The Epidemiology and Management of Lung Diseases in Sickle Cell Disease: Lessons Learned from Acute and Chronic Lung Disease in Cystic Fibrosis
2018, Pediatric Clinics of North AmericaCitation Excerpt :Despite the challenging clinical diagnosis of asthma in individuals with CF, multiple studies have demonstrated the benefit of asthma therapies in the CF population. Several randomized controlled trials have been performed to examine the impact of inhaled bronchodilators,28,29 montelukast,30 inhaled glucocorticoids,31–33 and systemic glucocorticoids34,35 on individuals with CF without a focus on distinguishing those with a concomitant asthma diagnosis or not. The definition of asthma in SCD often relies on whether asthma medication has been prescribed.
Bronchiectasis
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionNational consensus regarding the prescription of inhaled corticosteroids in cystic fibrosis
2014, Archives de PediatrieInhaled medication and inhalation devices for lung disease in patients with cystic fibrosis: A European consensus
2009, Journal of Cystic FibrosisCYSTIC FIBROSIS
2009, Feigin and Cherry's Textbook of Pediatric Infectious Diseases, Sixth Edition
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From Alpine Children's Hospital, Davos Platz, Switzerland
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Reprint requests: Wilfried H. Nikolaizik, MD, Alpine Children's Hospital, Scalettastr. 5, CH-7270 Davos Platz, Switzerland.
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0022-3476/96/$5.00 + 0 9/25/69629