Cited by 128Asthma and respiratory diseasesInhalation and Respiratory Drug DeliveryChronic Obstructive Pulmonary Disease (COPD) Research

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Chronotherapy of asthma with inhaled steroids: The effect of dosage timing on drug efficacy

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Pincus, Diane J., Szefler, Stanley J., Ackerson, Lynn M., Martin, Richard J.·1995·Journal of Allergy and Clinical Immunology

DOI 10.1016/s0091-6749(95)70073-0

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Abstract

Background Studies in asthma with systemic corticosteroids given at 3:00 PM have shown a superior therapeutic benefit compared with dosing at other time points.Objective The study was designed to compare beneficial and systemic effects of 800 micrograms of inhaled triamcinolone once daily at 3:00 PM (QD group) versus 200 micrograms conventional four times a day dosing (QID group).Methods Efficacy outcome measures included forced expiratory volume in 1 second (FEV1), peak expiratory flow rates, bronchial responsiveness, and use of beta-agonist. Systemic effects were blood eosinophil and cortisol levels, 24-hour urinary cortisol, and evaluation for oral candidiasis and dysphonia.Results The baseline FEV1 was comparable in the two groups: QD = 67% +/- 2% and QID = 66% +/- 2% of predicted value. After 4 weeks of treatment, FEV1 increased similarly in the QD group to 77% +/- 4% and in the QID group to 74% +/- 4% of predicted value. Likewise, the improvement in morning and evening peak expiratory flow rates was not significantly different between the groups. Both QD and QID groups experienced comparable daily decrements in beta-agonist use. The systemic responses to the two regimens as assessed by eosinophil count, morning serum cortisol, and 24-hour urinary cortisol were also comparable.Conclusions The single daily administration of inhaled triamcinolone at 3:00 PM has no increased systemic effects and produces similar improvement in efficacy variables. A dosing strategy based on once daily dosing should increase compliance of inhaled steroid use in the clinical setting.

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Authors: Pincus, D. J., Szefler, S. J., Ackerson, L. M., & Martin, R. J.
Affiliations: National Jewish Health (US)
ORCID: Szefler, Stanley J.
Martin, Richard J.
Venue: Journal of Allergy and Clinical Immunology
Publisher: Elsevier BV
Published: 1995-06
Volume: 95
Issue: 6
Pages: 1172-1178
ISSN: 0091-6749 (ISSN-L)
DOI: 10.1016/s0091-6749(95)70073-0
OpenAlex: W2150971973
Cited by: 128
References: 16
Citations by year: 2026: 2 · 2025: 1 · 2024: 3 · 2023: 5 · 2021: 5 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 5 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 3
FWCI: 3.99
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Allergy and Clinical Immunology (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (HL 36577, P01HL036577)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Inhalation and Respiratory Drug Delivery
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Keywords: asthma, inhaled corticosteroids, triamcinolone, chronotherapy, timing of drug administration, once-daily dosing, FEV1, peak expiratory flow, airway hyperresponsiveness, beta-agonist use, eosinophil count, serum cortisol, urinary cortisol, oral candidiasis, dysphonia, medication adherence
MeSH terms: Administration, Inhalation, Adrenergic beta-Agonists, Adult, Asthma, Cell Count, Eosinophils, Female, Humans, Hydrocortisone, Male, Middle Aged, Time Factors, Triamcinolone

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Chronotherapy of asthma with inhaled steroids: The effect of dosage timing on drug efficacy

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