THE EFFECT OF LONG-TERM SIMULTANEOUS THERAPY WITH SALBUTAMOL AND BUDESONIDE ON BRONCHIAL REACTIVITY AND SERUM ECP LEVEL IN ASTHMATICS

The effects of 20 weeks of regular application of salbutamol, in compa ratively high doses, on asthma symptoms, spirometry, bronchial reactiv ity, and the serum ECP level in asthmatics, who took inhaled corticost eroids, were studied. The studies were carried out on 20 nonsmoking, m ild or moderate, nonallergic patients with stable asthma, treated regu larly with inhaled corticosteroids and a beta(2)-agonist if required. After a 1-week run-in period the patients continued the inhalations of corticosteroids and took, on a fixed schedule, 800 mu g of salbutamol daily and more on demand. Examinations of the patients and spirometry were performed every 2 weeks. Before and after the treatment, bronchi al reactivity to histamine was tested and blood samples for ECP determ ination were taken. The symptom score, morning and evening PEF, and da ily number of beta(2)-agonist doses, taken on demand, were recorded on their diary cards. Small increases in the morning PEF and FEF(25-75) (P < 0.05) were observed before the end of the study. The variations i n evening PEFs, bronchial reactivity, serum ECP level, symptom score, and ''on demand'' bronchodilator consumption were not statistically si gnificant. Although the regular application of comparatively high dose s of the beta(2)-agonist in patients continuously treated with inhaled corticosteroids did not enhance bronchial reactivity, a significant i mprovement in control of asthma was not observed either. Despite quite high doses of the beta(2)-agonist, taken on a fixed schedule, from th e second week of the study most of the patients needed further doses t aken on demand. We support the position that short acting beta(2)-agon ists should be taken only on demand.