Influence of Beclomethasone and Salmeterol

Rackground: Patient evaluation of asthma severity and medication needs is mostly based on respiratory symptoms and may be influenced by changes in perception of bronchoconstrictioninduced sensations. However, the influence of asthma medication on the ability to perceive symptoms is still to be documented. This study evaluated the effects of short-term and regular use of salmeterol on the perception of methacholine-induced bronchoconstriction (MIB) in subjects with mild asthma, using inhaled salbutamol on an "as required" basis (n= 15), and in subjects with moderate asthma, using daily inhaled beclomethasone (mean daily dose, 640 |xg; n=15) in addition to salbutamol to control their asthma. Methods: Methacholine challenges (MC) were performed at entry into the study, and then before, 1, and 12 h following inhalation of 50 (xg of salmeterol or a placebo, after a 15-day baseline period; and after 4 weeks of twice daily use of those treatments. The measurements were then repeated with the alternate treatment after a 15-day washout period. Finally, a last MC was performed after another 15-day washout period. For each MC, the perception score of bronchoconstriction-associated breathlessness at 20% fall in FEV! (PS20) was evaluated on a modified Borg scale from 0 to 10.