THE INFLUENCE OF WITHDRAWAL OF BRONCHIAL ASTHMA MEDICATION ON RESPIRATORY FUNCTION TEST

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  • HIDA Noriko
    Department of Pharmacology Showa University School of Medicine
  • TEZUKA Miki
    Showa University Karasuyama Hospital, Clinical laboratory
  • KUMASAKA Arika
    Showa University Karasuyama Hospital, Clinical laboratory
  • SAMBE Takehiko
    Department of Pharmacology Showa University School of Medicine Showa University Clinical Research Institute for Clinical Pharmacology and Therapeutics
  • SUZUKI Tatsunori
    Showa University Clinical Research Institute for Clinical Pharmacology and Therapeutics
  • RYU Kakei
    Showa University Clinical Research Institute for Clinical Pharmacology and Therapeutics
  • YAMAZAKI Taigi
    Showa University Clinical Research Institute for Clinical Pharmacology and Therapeutics
  • HIROSAWA Makiko
    Department of Pharmacology Showa University School of Medicine
  • TANAKA Akihiko
    Division of Allergology and Respiratory Medicine, Showa University School of Medicine
  • OTA Shin
    Division of Allergology and Respiratory Medicine, Showa University School of Medicine
  • SAGARA Hironori
    Division of Allergology and Respiratory Medicine, Showa University School of Medicine
  • KOBAYASHI Shiniti
    Showa University Clinical Research Institute for Clinical Pharmacology and Therapeutics
  • UCHIDA Naoki
    Department of Pharmacology Showa University School of Medicine Showa University Clinical Research Institute for Clinical Pharmacology and Therapeutics

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Other Title
  • 軽症～中等症の気管支喘息患者における治療薬休薬が呼吸機能に及ぼす影響
  • ケイショウ~チュウトウショウ ノ キカンシ ゼンソク カンジャ ニ オケル チリョウヤクキュウヤク ガ コキュウ キノウ ニ オヨボス エイキョウ

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Abstract

The number of deaths caused by asthma attacks has been decreasing in recent years due to the widespread use of inhaled corticosteroid (ICS). However, in some poor adherence cases, severe asthma attacks have occurred and resulted in emergency visits and hospitalization. To date, there is no detailed examination report to evaluate the influence of temporary discontinuation of therapeutic drugs on a respiratory function test. Therefore, this clinical study was undertaken.<br>The clinical trial was performed at Showa University Clinical Research Institute for Clinical Pharmacology and Therapeutics from April to July in 2014, with 15 healthy subjects and 20 bronchial asthma patients enrolled in the study. For the respiratory function test FVC, FEV1.0, FEV1.0%, %FEV1.0, V25, V50, PEF were measured. The tests were conducted twice on different days and each parameter was analyzed comparatively. The use of long-acting inhaled β2 receptor agonists (LABA), anti-leukotriene agents, and anti-allergic agents for the asthma patients were discontinued in accordance with the study design before their second visit to the study site.<br>The test result in healthy subjects showed a significant increase in FEV1.0%, V50 and V25 on their second visit, while in the asthma patients a marked decrease in PEF was seen after stopping the medication. The decrease in PEF was particularly larger in patients using ICS and LABA compared to the non-users. This result indicates a decline of PEF in the patients with bronchial asthma due to the withdrawal of corresponding treatment even without the exacerbation of the subjective symptom. In conclusion, patient education regarding the improvement of adherence will be a very important for asthma control.

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