Inhaled steroids improve quality of life in patients with steady-state bronchiectasis

Respir Med. 2006 Sep;100(9):1623-32. doi: 10.1016/j.rmed.2005.12.002. Epub 2006 Jan 24.

Abstract

Background: The effects of inhaled steroids upon the quality of life of patients with bronchiectasis remain unknown.

Study objective: To analyze the effect of inhaled fluticasone propionate (FP) for 6 months upon the clinical, functional, microbiological and outcome parameters of patients with steady-state bronchiectasis not due to cystic fibrosis, and its repercussions for patient health-related quality of life (HRQoL).

Design: Prospective, randomized, double-blind (for effective doses) study.

Patients and interventions: The diagnosis of bronchiectasis was made by high-resolution computed tomography. Ninety-three patients (mean age: 68.5 [8.4]) were randomized to receive 250 microg bid, 500 microg bid or no treatment with inhaled FP for 6 months. Data were collected at baseline and at 1, 3 and 6 months after the start of treatment. HRQoL was assessed using the validated Spanish version of the St. George's Respiratory Questionnaire.

Results: The group administered FP 1000 microg daily showed significant improvement in dyspnea (1.03 [2.1]-1.24 [2.2] points; P = 0.01-0.04), sputum production (P = 0.001), days without cough (P = 0.02) and short-acting beta-2 agonists used (P = 0.01) from the first month of treatment, with no changes in pulmonary function, number or severity of exacerbations, or microbiological profile of the sputum. As a result, an improvement in HRQoL was seen in this group after 3 months of treatment (45.4 [14.2] vs. 40.5 [13.9]; P = 0.01).

Conclusions: Inhalatory FP 500 microg bid is effective from the first month of treatment for controlling the symptoms of patients with steady-state bronchiectasis-thus ensuring a significant improvement in HRQoL.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Aged
  • Androstadienes / administration & dosage*
  • Bronchiectasis / drug therapy*
  • Bronchodilator Agents / administration & dosage*
  • Cough / drug therapy
  • Double-Blind Method
  • Dyspnea / drug therapy
  • Female
  • Fluticasone
  • Forced Expiratory Volume
  • Humans
  • Male
  • Prospective Studies
  • Quality of Life
  • Respiratory Sounds
  • Vital Capacity

Substances

  • Androstadienes
  • Bronchodilator Agents
  • Fluticasone