The Effect of Long-Term Simultaneous Therapy with Salbutamol and Budesonide on Bronchial Reactivity and Serum ECP Level in Asthmatics

Abstract

ABSTRACT

The effects of 20 weeks of regular application of salbutamol, in comparatively high doses, on asthma symptoms, spirometry, bronchial reactivity, and the serum ECP level in asthmatics, who took inhaled corticosteroids, were studied. The studies were carried out on 20 nonsmoking, mild or moderate, nonallergic patients with stable asthma, treated regularly with inhaled corticosteroids and a β₂-agonist if required. After a 1-week run-in period the patients continued the inhalations of corticosteroids and took, on a fixed schedule, 800 μg of salbutamol daily and more on demand. Examinations of the patients and spirometry were performed every 2 weeks. Before and after the treatment, bronchial reactivity to histamine was tested and blood samples for ECP determination were taken. The symptom score, morning and evening PEF, and daily number of β₂-agonist doses, taken on demand, were recorded on their diary cards. Small increases in the morning PEF and FEF_25–75 (p < 0.05) were observed before the end of the study. The variations in evening PEFs, bronchial reactivity, serum ECP level, symptom score, and "on demand" bronchodilator consumption were not statistically significant. Although the regular application of comparatively high doses of the β₂-agonist in patients continuously treated with inhaled corticosteroids did not enhance bronchial reactivity, a significant improvement in control of asthma was not observed either. Despite quite high doses of the β₂-agonist, taken on a fixed schedule, from the second week of the study most of the patients needed further doses taken on demand. We support the position that short acting β₂-agonists should be taken only on demand.