Periodic treatment regimens with inhaled XXXX in @entity565 or @entity1030 . Is it possible?

@entity1 @entity2715 @entity13265 @entity2488 @entity565 @entity3045 @entity228 @entity189 @entity112 @entity1030 @entity230 @entity288
OBJECTIVE: To determine whether inhaled @entity288 can be discontinued in the stable phase of @entity565 or @entity1030 ( @entity1030 ) or if this therapy should be continued. DESIGN: Nonrandomized open uncontrolled 5-year trial. SETTING: Prospective study in general practice. @entity1 : Forty-eight @entity1 with steroid-dependent @entity565 or @entity1030 who had shown a decline in forced expiratory volume in 1 second (FEV1) of at least 80 mL per year and at least one exacerbation per year during the first 2 years of bronchodilator treatment. Subjects were treated additionally with inhaled @entity230 for another 2 years and were finally given the option to stop using @entity230 . Sixteen @entity1 were willing to stop using @entity2715 and were studied for another year. No recruitment bias took place in this consecutive sample in the fifth year of follow-up. Two of 16 @entity1 developed @entity189 and dropped out. INTERVENTIONS: Two years of bronchodilator treatment alone (400 micrograms of @entity3045 or 40 micrograms of @entity13265 four times daily), followed by 2 years of additional inhaled @entity228 treatment (400 micrograms of @entity2715 two times daily), and finally 1 year of bronchodilator treatment alone. MAIN OUTCOME MEASURES: Decline in lung function (FEV1), change in @entity2488 , indicated by a provocative concentration of @entity112 causing a 20% fall in FEV1 (PC20), morning peak expiratory flow rate (PEFR), diurnal PEFR, week-to-week variation of PEFR, bronchial symptoms, and exacerbations. RESULTS: The course of FEV1 during the year in which @entity2715 was discontinued was not significantly different when compared with the 2-year period of @entity2715 treatment. Neither did the course of PC20, morning PEFR, diurnal PEFR, symptom score, and exacerbation rate change. Only the week-to-week variation of the PEFR increased after discontinuing @entity230 . CONCLUSIONS: Discontinuing inhaled @entity230 is possible in some @entity1 with @entity565 or @entity1030 after 2 years of regular treatment. This might indicate that for certain groups of @entity1 with mild @entity565 or @entity1030 , periodic treatment schedules with inhaled @entity230 is the treatment policy for the future.
