Asthma, Corticosteroid Insensitivity, Smoking, Steroid Resistance
Conditions
Keywords
Asthma, Smoking, Steroid Resistance, Corticosteroid insensitivity
Brief summary
Smokers with asthma display a relative insensitivity to inhaled and oral corticosteroids. The causes of this phenomenon are currently unknown. The investigators will perform a number of blood & breathing tests to try to discover the cause/s behind this phenomenon with the aim of producing leads for further investigation and possible new treatments for smokers with asthma.
Detailed description
Smokers with asthma display a relative insensitivity to inhaled and oral corticosteroids. The causes of this phenomenon are currently unknown. However research into steroid resistance in severe asthma and the smoking related condition chronic obstructive pulmonary disease (COPD) points to a number of possible causes. We will characterise a group of smokers with asthma and perform a number of investigations and compare the results to ex-smokers and never smokers with asthma with the aim of establishing which previously published steroid resistance phenomena are related to the steroid resistance displayed by smokers with asthma. Results produced from this trial will provide hypothesis generating information leading to future pharmaceutical trials.
Interventions
2 week steroid trial
Sponsors
Study design
Eligibility
Inclusion criteria
* Asthma (defined by either reversibility to bronchodilator or methacholine testing) * Asthma duration of 6 months or greater * Stable asthma * Age 18-60 * Treatment with inhaled corticosteroids * Smoking history consistent with group * smokers with asthma: \> or = 5 pack years and currently smoking more than 5 cigarettes per day * ex-smokers: smoking ceased \> or = two years prior to recruitment, minimum 5 pack year history * non-smokers: no smoking history
Exclusion criteria
* Presence of medical condition likely to be exacerbated by treatment with oral corticosteroids * Treatment with \> 2000 mcg beclomethasone (or equivalent) per day * Subject requires oral corticosteroids to maintain asthma control * Subject requires oral theophylline to maintain asthma control * Recent treatment with oral corticosteroids * Pregnancy or subject planning to become pregnant
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| bronchodilator response to oral corticosteroid trial in smokers with asthma vs non smokers and ex-smokers with asthma | 2 weeks |
Countries
United Kingdom