TREATMENT OF STEROID-DEPENDENT BRONCHIAL-ASTHMA WITH CYCLOSPORINE

The treatment of chronic severe asthma is unsatisfactory for many pati ents, The aim of the study was to determine the effects of treatment o f steroid-dependent asthma with cyclosporin. We performed a double-bli nd, placebo-controlled, randomized, parallel group trial on the effect of cyclosporin on pulmonary function, asthma severity and tapering of prednisone in 34 steroid-dependent asthmatics (mean oral prednisone d ose: 16 mg . day(-1)). The study consisted of: 1) baseline period (12 weeks); 2) experimental period divided into two parts: Part I (12 week s) cyclosporin or placebo treatment; Part II (22 weeks) cyclosporin or placebo treatment and oral prednisone reduction; and 3) follow-up obs ervation (8 weeks), Asthma symptoms score, pulmonary function tests (d aily peak expiratory flow (PEF) and bi-weekly forced vital capacity (F VC), forced expiratory volume in one second (FEV(1)) and maximal mid-e xpiratory flow (MEF(50)), biochemical profile and blood cyclosporin le vels were monitored throughout the study. Following cyclosporin admini stration, a slight beneficial effect on some subjective parameters of asthma severity was observed, At the same time, no beneficial effect o n pulmonary function was noted, The time trends analysis of mean daily prednisone doses between the treatment groups revealed a statisticall y significant difference indicating that, during prednisone reduction, cyclosporin seemed to be slightly more efficient than placebo in redu cing the requirement for systemic corticosteroid, even though the ster oid reduction was accompanied by slight impairment of some pulmonary f unction, However, there was no significant difference in the final dos e reduction between the treatment groups. These data and the known tox icity of the drug suggest a limited place for cyclosporin treatment in steroid-dependent bronchial asthma.