Time-Effect of Formoterol Added to Inhaled Fluticasone on Exercise- Induced Bronchoconstriction in Asthmatic Adolescents

Background: Asthma is characterized by chronic airway inflammation that is controlled by a complex cytokine network. Inhaled corticosteroid and short acting β2-agonists treatment improve asthma control. Objective: The aim of the study is to evaluate if a combination of fluticasone and formoterol is effective to assure a protective effect against EIB 15 min and 4 hours after administration in adolescent with persistent asthma. Method: In this study we selected 20 adolescents age 8 and 19 years affected by mild to moderate persistent asthma and EIB. At screening the following were assessed: eligibility, demography, medical history, medications, spirometry and clinical examination. During the study all the patients continued to regularly take a low dose of inhaled steroids; albuterol as rescue medication has been discontinued 8 hours before the exercise test. Results: Formoterol plus fluticasone offered good protection against EIB in 18 patients (90%), the mean maximum percent fall in FEV1 after formoterol was 7.1 ± 4.9% at 15 min (p<0.001). The combination formoterol plus fluticasone was more effective after 4 hours protecting against bronchoconstriction 19 patients (95%) and the mean maximum percent fall in FEV1 after formoterol plus fluticasone was 4.3 ± 4.2% at 4 h (p < 0.001). Conclusions: This study suggests that fluticasone 100 mcg + formoterol 10mcg by MDI + spacer is effective in protecting asthmatic adolescents as early as 15 min after dosing. Furthermore, the data confirm the long duration of its protective effect and the absence of any significant adverse effects after administration.