Influence of cigarette smoking on inhaled corticosteroid treatment in mild XXXX .

@entity1 @entity748 @entity565 @entity230 @entity6587 @entity5023 @entity288
BACKGROUND: Although inhaled @entity288 have an established role in the treatment of @entity565 , studies have tended to concentrate on non-smokers and little is known about the possible effect of cigarette smoking on the efficacy of treatment with inhaled @entity230 in @entity565 . A study was undertaken to investigate the effect of active cigarette smoking on responses to treatment with inhaled corticosteroids in @entity1 with mild @entity565 . METHODS: The effect of treatment with inhaled @entity5023 (1000 microg daily) or placebo for 3 weeks was studied in a double blind, prospective, randomised, placebo controlled study of 38 steroid na  ve adult @entity748 @entity1 (21 non-smokers). Efficacy was assessed using morning and evening peak expiratory flow (PEF) readings, spirometric parameters, @entity6587 , and sputum eosinophil counts. Comparison was made between responses to treatment in non-smoking and smoking @entity748 @entity1 . RESULTS: There was a significantly greater increase in mean morning PEF in non-smokers than in smokers following inhaled @entity5023 (27 l/min v -5 l/min). Non-smokers had a statistically significant increase in mean morning PEF (27 l/min), mean forced expiratory volume in 1 second (0.17 l), and geometric mean PC20 (2.6 doubling doses), and a significant decrease in the proportion of sputum eosinophils (-1.75%) after @entity5023 compared with placebo. No significant changes were observed in the smoking @entity748 @entity1 for any of these parameters. CONCLUSIONS: Active cigarette smoking impairs the efficacy of short term inhaled corticosteroid treatment in mild @entity565 . This finding has important implications for the management of @entity1 with mild @entity565 who smoke.
