Prediction of treatment-response to inhaled corticosteroids by mannitol-challenge test in COPD. A proof of concept

Publication

Prediction of treatment-response to inhaled corticosteroids by mannitol-challenge test in COPD. A proof of concept

Journal Paper/Review - Jan 1, 2005

Leuppi Jörg D, Chan Hak-Kim, Greiff Lennart, Andersson Morgan, Knoblauch Andreas, Surber Christian, Perruchoud André P, Bingisser Roland, Brutsche Martin, Stolz Daiana, Anderson Sandra D, Tandjung Ryan, Tamm Michael

Citation

Leuppi J, Chan H, Greiff L, Andersson M, Knoblauch A, Surber C, Perruchoud A, Bingisser R, Brutsche M, Stolz D, Anderson S, Tandjung R, Tamm M. Prediction of treatment-response to inhaled corticosteroids by mannitol-challenge test in COPD. A proof of concept. Pulmonary pharmacology & therapeutics 2005; 18:83-8.

Type

Journal Paper/Review (English)

Journal

Pulmonary pharmacology & therapeutics 2005; 18

Publication Date

Jan 1, 2005

Issn Print

1094-5539

Pages

83-8

Brief description/objective

BACKGROUND: There are no predictors known that can identify COPD patients who will respond to treatment with ICS. METHOD: We investigated 30 patients (median age 65 (range 44-83, 12 females) with mild to moderately severe COPD. All patients had post bronchodilator FEV1/forced vital capacity ratio of less than 70% and a reversibility of less than 12% and 200 ml from baseline. We wanted to determine if airway responsiveness (AHR) to histamine and mannitol could predict who would respond to a 3-month course of ICS. RESULTS: At baseline, all patients had AHR to histamine, but only 7 (23%) patients to mannitol. After 3 months of treatment with ICS, there was no significant change in spirometry or the quality of life when analysing all individuals together. However, FEV1% predicted improved from 67% (IQR12) to 79% (IQR16) in mannitol positive patients; whereas it was unchanged in the mannitol negative patients. The difference in the mean change of FEV1% predicted between the two groups was 12 (IQR13.5) and this was highly significant (p=0.001). The improvement in quality of life (SGRQ 30 (IQR10.5) to 21 (IQR12; p=0.01) was only significant in the patients positive to mannitol. CONCLUSION: We propose that AHR to mannitol could predict ICS-responsiveness in mild to moderately severe COPD patients.