Proof of concept study to evaluate step-down therapy with inhaled corticosteroid alone or additive therapy on surrogate inflammatory markers in asthma

Lorna McKinlay, Peter A. Williamson, Philip M. Short, Thomas Fardon, Brian J. Lipworth

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    The aim of the study was to evaluate the usefulness of inflammatory surrogates in determining step-down therapy in asthma.


    AMP challenge, serum eosinophil cationic protein (ECP), exhaled nitric oxide (eNO) and pulmonary function tests were recorded. Subjects were divided into two groups following high dose inhaled corticosteroids (ICS): Group A fixed dose ICS vs. Group B ICS alone and in combination with add on therapies.


    No differences were seen in inflammatory measures between fixed dose ICS and reduced dose ICS alone or with combination therapies.


    AMP challenge conferred no additional benefit in guiding step-down therapy. The role of inflammatory surrogates may still play a role in predicting failed step-down on an individual basis.

    Original languageEnglish
    Pages (from-to)128-131
    Number of pages4
    JournalBritish Journal of Clinical Pharmacology
    Issue number1
    Publication statusPublished - Jan 2011


    • Adenosine monophosphate
    • Asthma
    • Exhaled nitric oxide
    • Management
    • Serum cationic protein
    • Fluticasone propionate
    • Dose-response
    • Hyperresponsiveness
    • Formulations

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