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Addition of inhaled corticosteroids to systemic immunosuppression after lung transplantation: a double-blind, placebo-controlled trial

Citation

Whitford, H and Walters, EH and Levvey, B and Kotsimbos, T and Orsida, B and Ward, C and Pais, M and Reid, S and Williams, T and Snell, G, Addition of inhaled corticosteroids to systemic immunosuppression after lung transplantation: a double-blind, placebo-controlled trial, Transplantation, 73, (11) pp. 1793-1799. ISSN 0041-1337 (2002) [Refereed Article]

DOI: doi:10.1097/00007890-200206150-00016

Abstract

Background. It is postulated that bronchiolitis obliterans syndrome (BOS) is preceded by airway inflammation that has been described even in stable lung transplant recipients. Airway inflammation is known to be suppressed by inhaled steroids in other chronic inflammatory lung diseases, e.g., asthma and chronic obstructive pulmonary disease. BOS is the major cause of morbidity and mortality after lung transplantation. Objective. To examine the effect of inhaled corticosteroids on the development of BOS in lung transplant recipients. Methods. Thirty patients were recruited and randomized in a double-blind fashion to receive either 750 μg of fluticasone propionate (FP) or an identical-appearing placebo twice daily for 3 months; 20 of this group continued until 2 years posttransplantation. Detailed spirometry was performed regularly through-out the study. Results. In the short-term study no differences were found in any examined parameters. In the long-term component of the study no differences were found in the development of neither BOS nor survival. There were minor differences in bronchoalveolar lavage (BAL) lymphocyte percentages. Conclusions. FP is ineffective for the prevention of BOS after lung transplantation despite the airway inflammation that characterizes this condition. Inadequate local delivery, timing of the therapy relative to transplantation and inherent steroid resistance of this condition may explain the negative finding of this study.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Respiratory Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Respiratory System and Diseases (incl. Asthma)
Author:Walters, EH (Professor Haydn Walters)
ID Code:24371
Year Published:2002
Web of Science® Times Cited:42
Deposited By:Medicine (Discipline)
Deposited On:2002-08-01
Last Modified:2003-03-18
Downloads:0

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