The Efficacy of Inhaled Beclomethasone in Chronic Obstructive Airway Disease

Hall, Thomas G.; Kasik, John E.; Bedell, George N.; Schaiff, Robyn

doi:10.1002/j.1875-9114.1989.tb04131.x

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…Early studies have suggested that there are no benefits of short term inhaled corticosteroids (2)(3)(4)(5)(6)(7)(8). However, many of these studies had a limited sample size.…”

Section: Short Term Clinical Studiesmentioning

confidence: 99%

Inhaled Corticosteroids Should Not Be Prescribed to All Chronic Obstructive Pulmonary Disease Patients

Bourbeau

McIvor

2003

Canadian Respiratory Journal

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“…Early studies have suggested that there are no benefits of short term inhaled corticosteroids (2)(3)(4)(5)(6)(7)(8). However, many of these studies had a limited sample size.…”

Section: Short Term Clinical Studiesmentioning

confidence: 99%

Inhaled Corticosteroids Should Not Be Prescribed to All Chronic Obstructive Pulmonary Disease Patients

Bourbeau

McIvor

2003

Canadian Respiratory Journal

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“…In the few studies where patients with COPD have been selected according to a significant response to oral corticosteroids, 2 3 the proportion of patients and the size of the eVect have been consistently less in patients receiving inhaled corticosteroids than in those receiving oral corticosteroids. In other studies [4][5][6][7][8][9][10][11] carried out in patients not previously selected for their response to oral corticosteroids, the results have been conflicting with regard to the physiological or functional eYcacy of an inhaled corticosteroid. Some studies have included patients with asthma 10 or younger patients with preclinical COPD.…”

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confidence: 99%

Randomised controlled trial of inhaled corticosteroids in patients with chronic obstructive pulmonary disease

Bourbeau

Rouleau

Boucher

1998

Thorax

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Background-Inhaled corticosteroids are known to be beneficial for patients with asthma, but their role in treating patients with stable chronic obstructive pulmonary disease (COPD) remains controversial. A study was undertaken to determine whether inhaled corticosteroids are of functional benefit in patients who did not show improvement with a trial of oral corticosteroids. Methods-In phase I patients with stable COPD were given a two week course of oral placebo followed by two weeks of prednisone 40 mg per day in a single blind manner to distinguish between responders and non-responders to oral corticosteroids. In phase II a double blind, randomised, parallel group trial of inhaled budesonide 1600 µg per day versus placebo was carried out in 79 nonresponders to oral corticosteroids. The primary outcome measure was forced expiratory volume in one second (FEV 1 ), and secondary outcome measures were exercise capacity, dyspnoea with exertion, quality of life, peak expiration flow rate, and respiratory symptoms. Results-Randomisation allocated 39 subjects to inhaled corticosteroids and 40 to placebo. There was no diVerence in the change in FEV 1 from baseline between the treatment and placebo groups; mean diVerence -12 ml (95% CI -88 to 63) at three months and -4 ml (95% CI -95 to 87) at six months. The proportion of patients with a 15% or greater improvement was no higher among those receiving inhaled corticosteroids than in the placebo group at any of the follow up visits. Changes in secondary outcomes were also no diVerent. Conclusions-Inhaled corticosteroids, even at high doses, were of no physiological or functional benefit in these patients with advanced COPD. (Thorax 1998;53:477-482)

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Does the ‘Oxygen cost diagram’ reflect changes in six minute walking distance in follow up studies?

Janssens

Breitenstein

Rochat

et al. 1999

Respiratory Medicine

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The oxygen cost diagram (OCD) is a simple scale for quantifying a patient's evaluation of his tolerance to exercise frequently used in clinical trials; it has been shown to be well correlated with objective measures of capacity of ambulation such as the 6 min walk test (6' W). This study aimed to determine whether the OCD accurately depicts changes in capacity of ambulation either quantitatively or qualitatively. OCD ratings were analysed at baseline and after a 1 yr follow-up, in patients treated by non-invasive home mechanical ventilation, as well as objective measurements of pulmonary function [forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), arterial blood gases], physical autonomy (6' W), resting dyspnoea (Borg scale) and scores for anxiety or depressive disorders (HAD). Forty-five patients (24 male, 21 female, aged 62 +/- 16 years, mean FEV1: 38 +/- 17% of predicted) were evaluated at baseline. OCD ratings were significantly correlated with 6 min walking distance (P < 0.0001)--although with a large variability around the regression line--but not with resting dyspnoea (Borg). Patients were re-evaluated after 352 +/- 90 days. Changes in OCD ratings were not significantly correlated with changes in FFV1 FVC, PaO2, PaCO2, 6' W, HAD scores or resting dyspnoea; furthermore--albeit for Borg scores--changes in OCD did not reflect the trend of changes in these parameters. These results show that although OCD ratings are well correlated with results of a 6' W test, they cannot be used to extrapolate individual performances, because of a large variability around the regression line, furthermore, changes in the OCD over 1 yr did not depict objective changes in 6' W test results, either quantitatively or qualitatively. The use of the OCD in clinical trials should be limited to the description of the patient's perception of exercise tolerance, as a component of health-related quality of life, with the awareness of possible discrepancies between changes in objective performances and changes in OCD ratings.

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The Efficacy of Inhaled Beclomethasone in Chronic Obstructive Airway Disease

Cited by 4 publications

References 12 publications

Inhaled Corticosteroids Should Not Be Prescribed to All Chronic Obstructive Pulmonary Disease Patients

Inhaled Corticosteroids Should Not Be Prescribed to All Chronic Obstructive Pulmonary Disease Patients

Randomised controlled trial of inhaled corticosteroids in patients with chronic obstructive pulmonary disease

Does the ‘Oxygen cost diagram’ reflect changes in six minute walking distance in follow up studies?

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