EXAMINATION OF THE EFFECTIVENESS OF SLOW AND DEEP INHALATION OF FP/FM-pMDI FOR THE SMALL-AIRWAYS DYSFUNCTION OF ADULT-ONSET ASTHMA.

BACKGROUNDS: To date adult-onset asthmatic patients who lack a clear stridor and show prolonged coughs and chest discomfort caused by small-airways dysfunction have increased. We examined the small-airways function of these cases and the effectiveness of slow and deep inhalation of FP/FM-pMDI. METHODS: 62 adult-onset asthmatic patients who had prolonged coughs and chest discomfort with the middle or high dose of ICS/LABA combination agents under well technique (32 of BUD/FM-DPI group and 30 of FP/SM-pMDI group) were included into this study. ICS/LABAs were switched to FP/FM-pMDI and slow and deep inhalation for 2-3 seconds was carried out thoroughly. The dose of FP/FM-pMDI was reduced depending on the improvement of symptoms. ACT score, respiratory function tests and respiratory resistance were measured after approximately six months from switching (stable condition after switching) and were compared with the values of the same period of the last year (stable condition under the previous ICS/LABA). RESULTS: After switching to FP/FM-pMDI, asthmatic symptoms and plural values of small-airways function were improved in 93.7% (30/32 cases) of BUD/FM-DPI group and in 86.6% (26/30 cases) of FP/SM-pMDI group. Moreover, mean daily inhalation doses were decreased from 5.0 to 4.3 in BUD/FM-DPI group and decreased from 5.7 to 3.7 in FP/SM-pMDI group. CONCLUSIONS: Slow and deep inhalation of FP/FM-pMDI is effective in many asthmatic patients who have prolonged small-airways dysfunction. A prospective, multi-centered contrastive study is warranted to confirm the effectiveness of this inhalational method.