alexa Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease.


Journal of Pulmonary & Respiratory Medicine

Author(s): Lung Health Study Research

Abstract Share this page

Abstract BACKGROUND: Chronic obstructive pulmonary disease (COPD) results from a progressive decline in lung function, which is thought to be the consequence of airway inflammation. We hypothesized that antiinflammatory therapy with inhaled corticosteroids would slow this decline. METHODS: We enrolled 1116 persons with COPD whose forced expiratory volume in one second (FEV1) was 30 to 90 percent of the predicted value in a 10-center, placebo-controlled, randomized trial of inhaled triamcinolone acetonide administered at a dose of 600 microg twice daily. The primary outcome measure was the rate of decline in FEV1 after the administration of a bronchodilator. The secondary outcome measures included respiratory symptoms, use of health care services, and airway reactivity. In a substudy of 412 participants, we measured bone density in the lumbar spine and femur at base line and one and three years after the beginning of treatment. RESULTS: The mean duration of follow-up was 40 months. The rate of decline in the FEV1 after bronchodilator use was similar in the 559 participants in the triamcinolone group and the 557 participants in the placebo group (44.2+/-2.9 vs. 47.0+/-3.0 ml per year, P= 0.50). Members of the triamcinolone group had fewer respiratory symptoms during the course of the study (21.1 per 100 person-years vs. 28.2 per 100 person-years, P=0.005) and had fewer visits to a physician because of a respiratory illness (1.2 per 100 person-years vs. 2.1 per 100 person-years, P=0.03). Those taking triamcinolone also had lower airway reactivity in response to methacholine challenge at 9 months and 33 months (P=0.02 for both comparisons). After three years, the bone density of the lumbar spine and the femur was significantly lower in the triamcinolone group (P < or = 0.007). CONCLUSIONS: Inhaled triamcinolone does not slow the rate of decline in lung function in people with COPD, but it improves airway reactivity and respiratory symptoms and decreases the use of health care services for respiratory problems. These benefits should be weighed against the potential long-term adverse effects of triamcinolone on bone mineral density. This article was published in N Engl J Med and referenced in Journal of Pulmonary & Respiratory Medicine

Relevant Expert PPTs

Relevant Speaker PPTs

  • Shoude Jin
    Mechanisms of Chronic obstructive pulmonary disease and airway smooth muscle remodeling: the potential roles of Abhd2
    PDF Version
  • Alsayed Alnahal
    Urinary netrin-1 predict early ischemic acute kidney injury after cardiopulmonary bypass
    PPT Version | PDF Version
  • Ping Yang
    Chronic obstructive pulmonary disease (COPD) complicating early-stage lung cancer (LC)
    PDF Version
  • Gunilla Lindqvist
    Chronic obstructive pulmonary disease: A study of the relationship between patients’ feeling of guilt due to their belief of the disease being self inflicted
    PDF Version
  • Roger Mark Engel
    The effect of including manual therapy in the management of mild chronic obstructive pulmonary disease – a randomized controlled trial
    PDF Version
  • Rupal Patel Mansukhani
    Correlation of Medication Therapy in Chronic Obstructive Pulmonary Disease(COPD) Patients with 30-day Readmission Rates
    PPT Version | PDF Version
  • Hadeel Faisal Gad
    In-vitro analysis of cytokines responses of visceral leishmaniasis and pulmonary tuberculosis patients to homologous and heterologous antigen stimulation
    PPT Version | PDF Version
  • Shivanand Reddy
    Relation between low serum testosterone level and peripheral arterial disease in men and clinical evaluation of effect of testosterone administration
    PPT Version | PDF Version
  • Xin Wang
    IL17 Pathway Involves Moderating Pulmonary Hypertension, a common complication of COPD, in Statins Therapy in Smoking Rats
    PPT Version | PDF Version
  • Alex Bekker
    Optimal Perioperative Management of Arterial Blood Pressure. How high is high? How low is low?
    PPT Version | PDF Version

Recommended Conferences

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version