[Effectiveness of inhaled corticosteroids (ics) combination therapy; the addition of qvar to flutide].

PURPOSE: We recently reported treatment of asthmatic patients with a combination of FP-DPI 800 microg/day and BDP-HFA 400 microg/day. This regimen induced significant improvement in subjective symptoms and pulmonary function tests. This led us to study the additive effect of BDP-HFA 400 microg/day for seven unstable severe persistent bronchial asthma patients. RESULTS: PEF improved, daily (circadian) variation was minimized and FVC and FEV1.0 testing showed slight improvement. V25/height also revealed significant improvement. The more peripheral the airways are, the greater improvement was observed. The annual emergency admission rate of 4.6 times per patient decreased to 2.1 times after the addition of BDP-HFA 400 microg/day. All the three cases dependent on oral steroid medication could be removed from the drug and 6 out of 7 cases were able to lower the dose of anti-asthmatic drugs. CONCLUSIONS: The effectiveness of inhaled corticosteroids (ICS) differs based on the site reached in the bronchi and depending on the inhalation devices used. Addition of a second ICS has the potential to further alleviate symptoms of unstable asthmatics on conventional therapy with ICS and other drugs.