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Title: High dose inhaled corticosteroid therapy in non asthmatic chronic airflow obstruction : a comparative study of the short term effect on lung function, symptoms, bronchial responsiveness, and peripheral neutrophil function, and observations on the long term role of such treatment
Author: Weir, David Cuthbertson
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1995
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This thesis has investigated and compared the short term effect of treatment with 750 micrograms and 1500 micrograms twice daily of inhaled beclomethasone dipropionate (BDP), and oral prednisolone 40 mg per day, on lung function and quality of life in 105 patients with non asthmatic chronic airflow obstruction. The role of physiological and clinical features in determining the response to treatment in individuals has been investigated, and the systemic and local side effects of therapy have been studied. The effect of treatment on peripheral neutrophil function has been investigated in a subgroup of patients, and observations on decline in FEV1 in a separate cohort of patients are presented. After three weeks treatment both doses of DBP produced equivalent, small but statistically significant improvements in FEV1, FVC, and mean PEF, compared to that seen with placebo. Individual patients demonstrated a response, defined on the changes seen in physiological variables, to active treatment more commonly than with placebo. Bronchial responsiveness to inhaled histamine was unaltered by treatment for three weeks with inhaled BDP. Quality of life and subjective measures of dyspnoea showed marked baseline variability, but treatment with BDP significantly improved dyspnoea and patient's 'mastery' over the disease. Oral prednisolone did not improve lung function or subjective measures further. A response to active treatment in individual patients was more common in those with more severe physiological impairment. Formal discriminant analysis was unsuccessful in predicting response to treatment in individual patients.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available