Inhaled steroids improve quality of life in patients with steady-state bronchiectasis

SummaryBackgroundThe effects of inhaled steroids upon the quality of life of patients with bronchiectasis remain unknown.Study objectiveTo analyze the effect of inhaled fluticasone propionate (FP) for 6 months upon the clinical, functional, microbiological and outcome parameters of patients with steady-state bronchiectasis not due to cystic fibrosis, and its repercussions for patient health-related quality of life (HRQoL).DesignProspective, randomized, double-blind (for effective doses) study.Patients and interventionsThe diagnosis of bronchiectasis was made by high-resolution computed tomography. Ninety-three patients (mean age: 68.5 [8.4]) were randomized to receive 250μg bid, 500μg bid or no treatment with inhaled FP for 6 months. Data were collected at baseline and at 1, 3 and 6 months after the start of treatment. HRQoL was assessed using the validated Spanish version of the St. George's Respiratory Questionnaire.ResultsThe group administered FP 1000μg daily showed significant improvement in dyspnea (1.03 [2.1]−1.24 [2.2] points; P=0.01–0.04), sputum production (P=0.001), days without cough (P=0.02) and short-acting beta-2 agonists used (P=0.01) from the first month of treatment, with no changes in pulmonary function, number or severity of exacerbations, or microbiological profile of the sputum. As a result, an improvement in HRQoL was seen in this group after 3 months of treatment (45.4 [14.2] vs. 40.5 [13.9]; P=0.01).ConclusionsInhalatory FP 500μg bid is effective from the first month of treatment for controlling the symptoms of patients with steady-state bronchiectasis—thus ensuring a significant improvement in HRQoL