Abstract
The method of transfer from oral to aerosol corticosteroids based on the kind of steroid and maintenance dosage was investigated by adding a beclomethasone dipropionate inhaler (BDI) in the treatment of steroid-dependent asthmatic adult patients.
On an average, 75% of steroid maintenance dosage was reduced, controlling clinical symptoms in six patients with an initial daily prednisolone dose of less than 7.5mg (5.4mg/day an average). Although the withdrawal rate of maintenance oral prednisolone dosage was 32% on an average, clinical symptoms were inadequately controlled and the symptom score of attacks during the last month was almost the same as in the control phase in seven patients with an initial daily prednisolone dose of more than 7.5mg (12.1mg/day on a average). In six betamethasone dependent patients of less than 0.75mg initial daily dose (0.51mg/day on a average), reduction of the daily maintenance dose was insufficient for 8 weeks.
Plasma cortisol levels were not increased significantly in all groups. In three steroid withdrawal patients, plasma cortisol levels were normal before BDI treatment or tended to improve in comparison to the control phase.
