Steroids slow decline in lung function in asthma

NEW YORK (Reuters Health) - Inhaled steroids not only control symptoms, they also appear to change the natural course of asthma over time, Danish researchers report in the journal Thorax.

Dr. Peter Lange at Hvidavre University Hospital and colleagues conducted a long-term study of 234 asthmatic patients, between 52 and 59 years of age, selected from the general population of Copenhagen. Patients were divided into two groups: 44 patients on maintenance therapy with inhaled steroids and the 190 patients who were not. The researchers measured forced expiratory volume in one second, an indicator of lung capacity (FEV1) annually over a 10-year period.

Lange reports that decline in FEV1 was 25 mL/year in those on inhaled steroids and 51 mL/year in asthmatics not on inhaled steroid therapy.

Age, socioeconomic status, body mass index, mucus hypersecretion and use of other asthma medications did not affect changes in lung function in either group.

Editorialist Dr. Pierre Ernst of the Royal Victoria Hospital in Montreal, cautions that "it behooves us to characterize our patients better in order to maximize the benefit of treatment in individual patients." He points out that "the prognosis of asthma is highly variable, with many patients having consistently mild disease."

Ernst describes inhaled steroids as the "mainstay of treatment." Maximum benefit requires regular treatment rather than occasional use in symptom control in asthma exacerbations.

SOURCE: Thorax, February 2006.