Contribution to the study of the etiopathogenic and background peculiarities in patients with corticodependent bronchial asthma. Note I. Concepts of corticodependence and pseudocorticodependence.

A group of 187 asthmatics that had been using corticotherapy for at least a year was studied to ascertain the actual necessity of this treatment as well as the clinical and etiologic forms of bronchial asthma in these patients. Thus 3 categories of patients could be delineated; 112 patients with total (permanent) corticodependence, 25 patients with transient (seasonal) corticodependence and 50 patients with pseudocorticodependence. Generally, the category with total corticodependence consisted of patients with intrinsic asthma or with confirmed polyintricated allergic asthma. The criteria for inclusion in this category were: lack of response to bronchodilating treatment, estimated clinically and by FEV1 and/or Raw (resistance of air ways) determinations, and impossibility to achieve corticotherapy "sevrage" by associating mast cell-degranulation inhibitors (ketotifen and/or disodium chromoglycat--DSCG). In the other two categories corticosteroid sevrage could be achieved either transiently in the case of the second category (corticodependent patients only in the warm season--asthmatics with allergy to pollens, resistant to the usual treatment--or in the cold season--some asthmatics with infectious trigger) or completely in the patients of the third category (with pseudocorticodependence). In these latter subjects (about a quarter of the patients with prolonged corticotherapy), mostly asthmatics with ignored allergic etiology, the etiologic approach of disease and the association of Ketotifen and/or DSCG led to disappearance of corticodependence.