The effect of ciclesnide on the airflow obstruction in the small airways and asthma-related quality of life in patients with asthma*
The small airways have recently attracted close attention as an important site of airway inflammation. The present study was undertaken to analyze the changes in the quality of life (QOL) and lung function following treatment with ciclesonide (HFA-CIC), with the goal of evaluating the usefulness of small-particle-sized inhaled corticosteroid (ICS) in the treatment of small airway lesions. The study was conducted on 10 patients with moderately persistent asthma who gave informed consent for participation in this study (5 males and 5 females with a mean age of 72 years). In these patients pulmonary function testing revealed persistent obstruction of the small airways even after treatment with another ICS (DPI preparation) at moderate or higher dose levels. After 4 weeks of observation, the ICS was switched to HFACIC that delivers a small particle sized aerosol. The latter was administered for 12 weeks. A QOL questionnaire survey was administered and pulmonary function testing was performed immediately before and 12 weeks after the drug switch. The results obtained after the switch were then compared with those documented prior to the switch. Inhalational treatment with HFA-CIC was associated with a significant improvement in the QOL. Although the forced expiratory volume in one second (FEV1) remained unchanged, a significant improvement of the Vdot50 was observed after inhalational therapy with HFA-CIC. No adverse reactions were apparent during the HFA-CIC treatment. Thus, the use of a small-particle-sized ICS (MDI preparation) resulted in an alleviation of small airway obstruction and an improvement in the QOL. If an ICS suitable for individual cases can be used, better responses to treatment may be obtained. (Accepted on December 13, 2010)
