Effect of inhaled indomethacin in asthmatic patients taking high doses of inhaled corticosteroids |
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Authors: | Jun Tamaoki MD Junko Nakata MD Kazuyuki Nishimura MD Mitsuko Kondo MD Kazutetsu Aoshiba MD Kiyomi Kawatani MD Atsushi Nagai MD |
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Institution: | a the First Department of Medicine, Tokyo Women’s Medical University School of Medicine Tokyo, Japan;b the Department of Medicine, Airi Hospital Tokyo, Japan;c the Department of Respirology, Kurihashi-Saiseikai Hospital Tokyo, Japan;d the Department of Respiratory Medicine, Ayase-Minshu Hospital Tokyo, Japan;e Hamacho Center Clinic, Tokyo. Tokyo, Japan |
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Abstract: | Background: Cyclooxygenase products of arachidonic acid may play a part in bronchoconstriction and airway inflammation in asthma. Objective: We sought to determine the effect of inhaled indomethacin on asthma control and asthma exacerbations during reduction of inhaled corticosteroids in patients with moderate-to-severe steroid-dependent asthma. Methods: We conducted a double-blind, randomized, parallel-group, multicenter study in 38 patients with asthma taking high doses (≥1500 μg/d) of beclomethasone dipropionate (BDP). After a run-in period, patients were assigned inhaled indomethacin (50 mg/d) or placebo for 6 weeks, during which the daily doses of BDP were reduced to half at week 2 and then to one third of the baseline dose at week 4. Results: Data were available from 34 patients. After the reduction of BDP doses, FEV1, peak expiratory flow, asthma symptoms, and exhaled nitric oxide concentrations deteriorated in both treatment groups, but these effects were less pronounced in the indomethacin group compared with the placebo group. During the 6-week treatment period, 89% of the patients receiving placebo had relapse of asthma, whereas only 38% of those receiving inhaled indomethacin did so (P = .003). Conclusion: Inhalation of indomethacin can reduce asthma exacerbations induced by reduction of high-dose inhaled corticosteroid in steroid-dependent asthma. (J Allergy Clin Immunol 2000;105:1134-9.) |
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Keywords: | Indomethacin corticosteroid airway inflammation nitric oxide asthma |
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