Benefits of budesonide similar in smoking and non-smoking asthmatics
MedWire News: Smokers and non-smokers with asthma gain similar benefits from budesonide therapy in terms of limiting their lung function decline, research shows.
Previous studies have suggested that, in addition to the deleterious effect on lung function, smoking is also associated with reduced efficacy of inhaled corticosteroid (ICS) treatment in patients with asthma, explain Paul O'Byrne (McMaster University Medical Center, Hamilton, Ontario, Canada) and team.
To assess the effects of low-dose inhaled budesonide on lung function in smokers and nonsmokers with mild, persistent asthma, the team studied 2924 patients, aged at least 18 years, with the respiratory condition who participated in the START (inhaled Steroid Treatment As Regular Therapy in early asthma) study. Of the participants, 492 were regular smokers.
The participants were randomly assigned to take either inhaled budesonide 400 µg once daily or placebo and were followed-up for 3 years.
Regular lung function tests revealed that smokers assigned to take placebo experienced a mean decline of 263.9 ml in post-bronchodilator FEV1 over the 3-year period compared with a mean decline of 180.8 ml among non-smokers taking placebo.
Among patients assigned to take budesonide, smokers experienced a mean decline of 192.4 ml in post-bronchodilator FEV1 over the study period while non-smokers experienced a mean decline of 134.3 ml.
Budesonide treatment was also associated with significantly improved pre-bronchodilator FEV1 in both groups, compared with placebo, the researchers note in the journal Chest.
O'Byrne and team conclude: “Smoking is associated with an accelerated decline in FEV1 in patients with mild, persistent, newly diagnosed asthma.
“Low-dose budesonide treatment significantly reduced the absolute decline in FEV1 to a similar extent in asthmatic patients who smoke and those who do not smoke.”
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By Mark Cowen