- The Lung Health Study Research Group.
Effect of Inhaled Triamcinolone on the Decline in Pulmonary Function in Chronic Obstructive Pulmonary Disease.
NEJM, 343 (26), December 28, 2000.p.1902-9
Chronic obstructive pulmonary disease (COPD) results from progressive decline in lung function which is thought to be the consequence of lung inflammation. Authors hypothesized that anti-inflammatory therapy with inhaled corticosteroids would slow this decline.
Patients with COPD (1116 persons) with FEU1 of 30-90% of predicted value (10 centres) were enrolled, in a placebo-controlled randomized trial of inhaled triamcinolone acetonide administered in the dose of 600 mg twice daily. Primary outcome measure was rate of decline in FEU1 after administration of a bronchodilator. Secondary outcome measures were respiratory symptoms, use of health care services and airway reactivity. Bone density was measured at base line and 1 and 3 years after beginning treatment.
The conclusions were that inhaled traimcinolonic does not slow the rate of decline in lung function in people with COPD, but improves reactivity and respiratory symptoms and decreases the use of health care services for respiratory symptoms. These benefits should be weighed against the potential long-term adverse effects of triamcinolonic on bone mineral density.