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Title: Anti-inflammatory Therapy Improves Symptoms but Not FEV1 in Asthmatics: Presented at ATS

"Anti-inflammatory Therapy Improves Symptoms but Not FEV1 in Asthmatics: Presented at ATS"

By Mike Fillon Special to DG News ATLANTA, GA -- May 23, 2002 -- Aggressive use of anti-inflammatory therapy in patients with asthma may not control their disease, but may only manage the symptoms, masking the deterioration in lung function. "This is a relatively new finding that contradicts earlier studies," said lead researcher David Kaelber, MD, PhD, from Case Western Reserve School of Medicine in Cleveland, Ohio, United States. "The assumption has been that if symptom severity is controlled and patients are feeling better, that they are getting better. We found they're not and instead, have significant decrease in functional lung volume over time." The study was presented here Wednesday at ATS 2002, the American Thoracic Society's 98th International Conference. The researchers analyzed the records of 111 adult asthmatics inner city and tracked them for two years, to investigate if disease management as per National Asthma Education and Prevention Program (NAEPP) Guidelines can prevent excessive loss of lung function. Subjects, recruited from the MetroHealth Center in Cleveland, were 74 percent female; 31 percent Caucasian, 49 percent African American and 20 percent Hispanic. The average age was 47 years. Each subject had at least nine determinations of clinical and functional status, and smoked less than 15 pack years. The average length of time with asthma was 17.5 years, and each had received treatment at the clinic for two years. At enrollment, the average pre-bronchodilator forced expiratory volume in one second (FEV1) score was 2.10; 80 percent had moderate to severe persistent symptoms; and 41 percent used no inhaled steroids. By six month follow-up, symptom severity declined an average of 21 percent (moderate to severe persistent) and averaged pre-bronchodilator FEV1 increased 10 percent. In the subsequent 24 months, 95 percent of patients required inhaled steroids (52 percent high dose), but no deterioration in symptoms or averaged lung function occurred. Although personal best post-bronchodilator FEV1 increased 16 percent by 6 months to 2.60, this parameter decreased 177 mL over the subsequent 24 months. "We believe these deceases are just the tip of the iceberg," Dr. Kaelber said. "We've tracked these patients for two years now, and we believe this objective decrease in lung function, as it continues, will cause the symptoms to continue to deteriorate."

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