Tsukino M, Ikeda A, Nishimura K
Department of Pulmonary Medicine, and Environmental Respiratory Disease, Kyoto University.
Nihon Rinsho. 1996 Nov;54(11):2982-6.
Effects of reducing or stopping inhaled beclomethasone dipropionate (BDP) on airway hyperresponsiveness (AHR) were evaluated in stable chronic asthma. In 16 patients, after the best control (no symptoms, peak expiratory flow rate [PEF] > 80% best) was achieved for at least 3 months, the dose of BDP was reduced to 2/3 to 1/2. No differences were observed in the mean FEV1, PEF and AHR between before and 3 months after the reduction of BDP. In 7 patients, after the almost normal level of AHR was achieved, the dose of BDP was gradually reduced and then discontinued. Three out of the 7 patients had maintained the adequate level of AHR over 14 months, but in the other 4 patients AHR deteriorated below normal level and re-administration of BDP was needed due to worsening of symptoms and PEF. In conclusion, a gradual reduction of the dose of BDP is possible, if the best control is achieved for at least 3 months. The possibility of discontinuation of BDP may exist in some patients after achieving adequate AHR.
在稳定期慢性哮喘患者中评估了减少或停用吸入丙酸倍氯米松（BDP）对气道高反应性（AHR）的影响。16例患者在达到最佳控制（无症状，呼气峰值流速[PEF]>最佳值的80%）至少3个月后，将BDP剂量减至2/3至1/2。BDP减量前与减量后3个月之间，平均第一秒用力呼气容积（FEV1）、PEF和AHR均未观察到差异。7例患者在达到几乎正常的AHR水平后，逐渐减少BDP剂量，然后停药。7例患者中有3例在14个月以上维持了足够的AHR水平，但其他4例患者的AHR恶化至低于正常水平，由于症状和PEF恶化，需要重新使用BDP。总之，如果达到最佳控制至少3个月，可以逐渐减少BDP剂量。在一些患者达到足够的AHR后，可能存在停用BDP的可能性。
