Oral corticosteroids are effective drugs for controlling the symptoms of asthma. The principal objectives in the use of an aerosolized corticosteroid are to control the asthmatic symptoms and to improve pulmonary function by the application of small local doses which will not cause either local or systemic side effects. In our study, we attained that objective.
For example, the patients who received triamcinolone acetonide aerosol for four weeks had highly significant (P<0.001) improvements in pulmonary function test results, asthma symptoms (except cough), and number of nights awakened by asthma. The patients who received placebo aerosol for four weeks exhibited no statistically significant improvement in pulmonary function tests or in the wheeze or cough asthma symptoms treated by ventolin or some other inhalers. However, shortness of breath, tightness in chest, and number of nights awakened by asthma parameters improved at the P<0.05 level in the placebo-treated patients. This symptomatic improvement observed in the placebo group is difficult to explain, but could represent a positive conditioning effect. The difference between the active-med-ication and placebo-treated groups was statistically significant (P<0.001) in favor of the active-medica-tion group for every parameter except cough. Plasma-cortisol changes were not statistically significant within or between groups.
Those patients who received TAA aerosol for the 21-month follow-up period exhibited highly significant (P<0.001) improvement in pulmonary function tests and all asthma symptoms. No significant change from baseline occurred in plasma-cortisol levels.
The side effects which appeared during both phases of this study did not cause discontinuance of therapy in any instance. The rate of oral candidal infection in our study agreed with that recently reported for triamcinolone acetonide aerosol.
Thus, triamcinolone acetonide aerosol was safe and effective as short-term or as long-term treatment in tins series of steroid-independent, bronchial asthma patients.