Long-term changes in airway-wall thickness on computed tomography in asthmatic patients

Background: effects of long-term treatment with inhaled corticosteroids (icss) on airway-wall thickness in patients with asthma remain unknown. objectives: to determine whether airway-wall thickness consistently decreases after long-term ics treatment,and to analyze factors contributing to long-term airway-wall changes in asthmatics. methods: a retrospective analysis of long-term changes in airway-wall thickness using computed tomography was performed in 14 patients with asthma. wall area corrected by body surface area (wa/bsa) was examined at baseline,12 weeks after the commencement of icss (second measurement),and at least 2 years (mean±sem. 4.2±0.5) after the second measurement (third measurement). mean±sem changes in wa/bsa from the second to the third measurements were analyzed. results: the mean change in wa/bsa was not significant between the second and the third measurements (-0.27±0.59 mm2/m2/y). overall,the changes were significantly associated with disease duration but not with other clinical indices. when the 14 patients were divided into 2 groups using a cutoff value of 0.32 mm2/m2/y for the mean change in wa/bsa,for the 5 patients whose wa/bsa exceeded this cutoff,daily ics doses were not reduced and both forced expiratory volume in the first second (fev1) and forced vital capacity decreased significantly. for the remaining 9 patients,daily ics doses were reduced and long-term fev1 values did not change. conclusions: despite long-term treatment with icss,airway-wall thickness did not consistently decrease. one possible mechanism underlying poor response to long-term treatment may be long-standing asthma. © 2011 esmon publicidad.