Differential effects of inhaled corticosteroids in smokers/ex-smokers and nonsmokers with asthma

Nicolas Roche; Dirkje S Postma; Gene Colice; Anne Burden; Theresa W Guilbert; Elliot Israel; Richard J Martin; Willem M C van Aalderen; Jonathan Grigg; Elizabeth V Hillyer; Julie von Ziegenweidt; David B Price

doi:10.1164/rccm.201411-2116LE

Differential effects of inhaled corticosteroids in smokers/ex-smokers and nonsmokers with asthma

Nicolas Roche, Dirkje S Postma, Gene Colice, Anne Burden, Theresa W Guilbert, Elliot Israel, Richard J Martin, Willem M C van Aalderen, Jonathan Grigg, Elizabeth V Hillyer, Julie von Ziegenweidt, David B Price

Research output: Contribution to journal › Article › peer-review

24 Citations (Scopus)

Abstract

Cigarette smoking decreases corticosteroid sensitivity in patients with asthma and worsens their symptoms and exacerbation frequency. Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment. However, the optimal therapies for smokers with asthma are not well deﬁned because smokers (and ex-smokers with a >10 pack-year history) are usually excluded from clinical trials. Exposure to even low levels of cigarette smoke is known to induce small airway inﬂammation (5, 6), which is associated with worse asthma control. Therefore, ICS deposition in small airways, which increases with small- versus standard-size–particle ICS, might be an important determinant of ICS effectiveness in smokers with asthma.

Original language	English
Pages (from-to)	960-964
Number of pages	5
Journal	American Journal of Respiratory and Critical Care Medicine
Volume	191
Issue number	8
DOIs	https://doi.org/10.1164/rccm.201411-2116LE
Publication status	Published - 15 Apr 2015

Bibliographical note

Supported by an unrestricted grant from Teva Pharmaceuticals Limited of Petach Tikva, Israel (for data acquisition and analysis). Access to data from the Optimum Patient Care Research Database was cofunded by Research in Real-Life Ltd.

Keywords

Inhaled Corticosteroids
Smokers
Ex-Smokers
Non Smokers
Differential Effects

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Roche, N., Postma, D. S., Colice, G., Burden, A., Guilbert, T. W., Israel, E., Martin, R. J., van Aalderen, W. M. C., Grigg, J., Hillyer, E. V., von Ziegenweidt, J., & Price, D. B. (2015). Differential effects of inhaled corticosteroids in smokers/ex-smokers and nonsmokers with asthma. American Journal of Respiratory and Critical Care Medicine, 191(8), 960-964. https://doi.org/10.1164/rccm.201411-2116LE

Roche, N, Postma, DS, Colice, G, Burden, A, Guilbert, TW, Israel, E, Martin, RJ, van Aalderen, WMC, Grigg, J, Hillyer, EV, von Ziegenweidt, J & Price, DB 2015, 'Differential effects of inhaled corticosteroids in smokers/ex-smokers and nonsmokers with asthma', American Journal of Respiratory and Critical Care Medicine, vol. 191, no. 8, pp. 960-964. https://doi.org/10.1164/rccm.201411-2116LE

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abstract = "Cigarette smoking decreases corticosteroid sensitivity in patients with asthma and worsens their symptoms and exacerbation frequency. Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment. However, the optimal therapies for smokers with asthma are not well deﬁned because smokers (and ex-smokers with a >10 pack-year history) are usually excluded from clinical trials. Exposure to even low levels of cigarette smoke is known to induce small airway inﬂammation (5, 6), which is associated with worse asthma control. Therefore, ICS deposition in small airways, which increases with small- versus standard-size–particle ICS, might be an important determinant of ICS effectiveness in smokers with asthma.",

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AU - Martin, Richard J

AU - van Aalderen, Willem M C

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AB - Cigarette smoking decreases corticosteroid sensitivity in patients with asthma and worsens their symptoms and exacerbation frequency. Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment. However, the optimal therapies for smokers with asthma are not well deﬁned because smokers (and ex-smokers with a >10 pack-year history) are usually excluded from clinical trials. Exposure to even low levels of cigarette smoke is known to induce small airway inﬂammation (5, 6), which is associated with worse asthma control. Therefore, ICS deposition in small airways, which increases with small- versus standard-size–particle ICS, might be an important determinant of ICS effectiveness in smokers with asthma.

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KW - Ex-Smokers

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JF - American Journal of Respiratory and Critical Care Medicine

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ER -

Differential effects of inhaled corticosteroids in smokers/ex-smokers and nonsmokers with asthma

Abstract

Bibliographical note

Keywords

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