Halting treatment with inhaled corticosteroids in patients with chronic obstructive pulmonary disease (COPD) is associated with both a higher risk and more rapid onset of exacerbations, together with a significant deterioration in health-related quality of life. The Dutch researchers studied 244 patients who received a high dose of inhaled corticosteroid (ICS) for four months during a run-in phase. The group was then randomized either to continue ICS treatment or to receive placebo for six months. In the ICS group of 123 individuals, 58 patients (47 percent) developed at least one exacerbation compared with 69 (57 percent) in the 121-person placebo group. In the placebo group, 26 patients experienced rapid recurrent exacerbations and had to be placed on ICS therapy again. Among the patients receiving ICS, only six were affected in this way. With regard to the health-related quality of life in the placebo group, those participants showed a significant deterioration in the total score, symptoms, and activity domains on a respiratory questionnaire. The research appears in the second issue for November 2002 of the American Journal of Respiratory and Critical Care Medicine.

LONGER AIRWAY IN MEN RAISES POTENTIAL FOR PHARYNGEAL COLLAPSE

Because of a substantially longer airway, men are much more predisposed to pharyngeal collapse than women, which investigators believe could explain their much higher risk of obstructive sleep apnea. In addition to their substantially longer pharyngeal airways, men also had an increased cross-sectional area of soft palate and increased airway volume. Based on an in-depth study of 19 males and 20 females to determine the anatomic and physiologic variables that are mechanistically important in pharyngeal behavior, the researchers constructed a model of a human upper airway. Then they used this mo
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Contact: Cathy Carlomagno
ccarlomagno@thoracic.org
212-315-6442
American Thoracic Society
18-Nov-2002