Effect of corticosteroid therapy on postponed outcomes of bronchial asthma
Abstract
Postponed outcomes of bronchial asthma were studied in 55 patients by urgent method. During 5—10 years, continuous therapy with inhalation corticosteroids (CS) as well as in combination with oral ones was prescribed to 17 patients (group A). Ten patients were medicated with CS episodically (group B), and 28 patients weren’t medicated with CS (control group). Ten year survival without fatal outcome (death, hazardous to life state development, invalidisation due to bronchial asthma) was 76±10% in the A group, 23±10% in the B one, and 42±9% in the control one (pA-B< 0.05 ; pA-C < 0.05; pB--C > 0.05). The most of cases of unfavourable bronchial asthma outcomes in the A group were noted during the first year of the CS therapy use. The obtained results allow to consider that a) prolonged continuous CS therapy enable to improve the postponed prognosis of bronchial asthma; b) defensive CS action develops gradually; c) irregular CS use does not improve the postponed prognosis of bronchial asthma; d) antiinflammation CS therapy absence is matched by high frequency of postponed unfavourable outcomes (up to 50%).
About the Authors
M. V. Sheyanov
Кафедра внутренних болезней № 1 1-го лечебного факультета ММА им. И.М.Сеченова
Russian Federation
Russian Federation
S. I. Ovcharenko
Кафедра внутренних болезней № 1 1-го лечебного факультета ММА им. И.М.Сеченова
Russian Federation
Russian Federation
V. I. Makolkin
Кафедра внутренних болезней № 1 1-го лечебного факультета ММА им. И.М.Сеченова
Russian Federation
Russian Federation
References
1. American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma / / Am. Rev. Respir. Dis.— 1987.— Vol. 136.— P.225—243.
2. British Thoracic Society. Guidlines for management of asthma in adults, I: chronic persistent asthma / / Br. Med. J.— 1990.— Vol.301.— P.651—653.
3. Burge P.S., Efthimiou J., Turner-Warwick М., Nelmes P.T.J. / / Clin. Allergy.— 1982.— Vol.12,— Р.523— 531.
4. Cohan V.L., Undem B.J., Fox C.C. et al. / / Am. Rev. Respir. Dis.— 1989.— Vol. 140.— P.951—954.
5. Diukanovic R., Wilson J.W., Britten KM. et al. / / Ibid.— 1992.— Vol.145.— P.669—674.
6. Dompeling E., van Schayck C.P.. van Grunsven P.M. et al. / / Ann. Intern. Med.— 1993,— Vol. 118,— P.770— 778.
7. Ellul-Micallef R., Borthwick R.C., McHardy G.J.R. / / Clin. Sci.— 1974.— Vol.47.— P.105— 117.
8. Ernst P., Spitzer W.O., Suissa S. et al. / / J.Am. Med. Assoc.— 1992.— Vol.26 8.— P.3462—3464.
9. Haahtela Т., Jarvinen М., Kava T. et al. / / N. Engl. J. Med.— 1991.— Vol.325.— P.388—392.
10. International consensus report on diagnosis and management of asthma. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland / / Eur. Respir. J.—1992.— Vol.5.— P.601—641.
11. Jeffery P.K., Godfrey R.W., Adelroth E. et al. / / Am. Rev. Respir. Dis.— 1992.— Vol. 145.— P.890—899.
12. Kaplan E.L., Meier P. / / J. Am. Stat. Assoc.— 1958.—Vol.53.— P.457—481.
13. Laitinen L.A., Laitinen A., Haahtela T. / / J. Allergy Clin. ImmunoL— 1992,— Vol.90.— P.32—42.
14. Lundgren R., Soderberg М., Horstedt P., Stealing R. / / Eur. Respir. J.— 1988.— VOL.l.— P.883—889.
15. Medical Products Agency (Lakemedelsverket). Workshop: Pharmacological Treatment of Bronchial Asthma. II.— Uppsala, 1993.— P.l — 186.
16. National Asthma Education Program. Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma.— Bethesda, 1991.— Publ.91—3042.
17. Phear D., Ball K., Page F. / / Lancet.— 1960.— Vol. l.— P.139— 141.
18. Rees H.A., Williams D.A. / / Br. Med. J.— 1962.— Vol.l.— P.1575— 1579.
19. van Essen-Zandvliet E.E., Hughes M.D., Waalkens H.J. et al. / / Am. Rev. Respir. Dis.— 1992.— Vol.146.— P.547—554.
Review
For citations:
Sheyanov M.V., Ovcharenko S.I., Makolkin V.I. Effect of corticosteroid therapy on postponed outcomes of bronchial asthma. PULMONOLOGIYA. 1995;(4):64-67. (In Russ.)
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