Long-term intervention in childhood asthma

In this thesis we first describe what is known from the literature on the effect of asthma drugs on airway responsiveness to histamine and methacholine (Chapter II). Chapter Ill describes the results of an acute effect study of an inhaled corticosteroid on AHR (sensitivity) to methacholine. In Chapter IV a study in children in which the effect of an inhaled corticosteroid was compared with the effect of a beta,-agonist on airway caliber, airway responsiveness to methacholine and symptoms during a period of 6 months is described. Chapter V describes the results of the first part of the multicenter study, in which the effect of long-term treatment with an inhaled beta,-agonist plus an inhaled corticosteroid was compared with the effect of an inhaled beta,-agonist-only on clinical endpoints, airway caliber, bronchodilator response and airway responsiveness to histamine. This part had to be discontinued after a median treatment period of 22 months because of the high withdrawal rate in the beta,agonist- only group. The second part of the study was concerned with the continuation of the patients on beta,-agonist plus inhaled corticosteroid up to 28 to 36 months after randomization, in which the further course of endpoints was studied and the remission rate was evaluated. The results are described in Chapter VI. The third part deals with the effect of cessation of inhaled corticosteroid in those children on inhaled corticosteroid who had a follow-up of at least 28 months on July 1, 1991 (Chapter VII).

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