Withdrawal of inhaled corticosteroid therapy in long-term, stable, mild to moderate, persistent asthmatic patients.

We aimed to evaluate the effect of withdrawal of inhaled corticosteroid (ICS) therapy on the course of mild to moderate asthma. Nineteen cases with stable, mild to moderate asthma were included in this study. Patients had used ICSs regularly during the past year and had no symptoms and signs for the last 3 months prior to the study. The patients were randomized into two groups. Group 1 included 11 patients who were followed after withdrawal of ICS therapy (mean age 48.8 +/- 13.1 years; M/F: 2/9), while Group 2 included 8 patients still taking ICS therapy (mean age 47.2 +/- 14.8 years; M/F: 4/4). All subjects were seen at the end of the 1st (V2), 2nd (V3), 3rd (V4), 6th (V5), and 12th (V6) months. Symptom scores and FEV1 measurements were evaluated during these visits. Patients with relapses were excluded from the study. Bronchial challenge test was applied in all cases at V0, V4, V5, and V6. In 10 of 11 cases (90.9%) in which ICS therapy was discontinued, relapse was observed in 1.55 +/- 0.86 months, while in 2 of 8 subjects (25%) still taking ICSs, relapse occurred after 3.76 +/- 1.99 months. In Group 1, "mean symptom score" and "mean PC20FEV1" values measured during the whole follow-up period were found to be lower than in Group 2. We concluded that withdrawal of ICS therapy could increase the possibility of relapse in mild to moderate asthma even in asymptomatic and stable cases.