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Keep this study
Lead
University of Nottingham
With
Nottingham University Hospitals NHS Trust
University Hospitals, Leicester
We have identified a group of patients with refractory asthma who have ongoing eosinophilic airway inflammation despite high dose inhaled corticosteroids.
Traditional inhaled steroids have a relatively proximal airway distribution which may lead to inadequate treatment of the distal airways.
We aim to demonstrate that a steroid inhaler with a smaller particle size which targets the distal airways can be a useful additional treatment option in this group of patients.
Age
18–80
Sex
ALL
Healthy volunteers
Not accepted
You may be eligible if
Age 18-80
ACQ \>1.5 or a requirement for oral steroids twice a year or more
High dose inhaled steroid (\>1000mcg BDP or equivalent)
Treatment with or unsuccessful trial of:
* long-acting beta agonist
* leukotriene antagonist
Sputum eosinophil count \>3% despite high dose inhaled steroid or \>2% with serum eosinophils \>0.4x10exp9/l
Clinical response to 2 weeks of oral prednisolone: (any one)
* reduction in ACQ by 0.5 or more
* increase in FEV1 by 200ml
* normalisation of exhaled nitric oxide or reduction of \>25ppb
You may not be if
Current smoker, or ex-smoker for \<12 months
Current treatment with an extrafine steroid inhaler
Respiratory infection within the last 4 weeks
Pregnancy or lactation
Poor compliance with usual asthma medication
Clinical diagnosis of significant bronchiectasis
Use of a medication which may interact with ciclesonide:
* ketoconazole or itraconazole
* ritonavir, nelfinavir
Clareo Health | Small Particle Steroids in Refractory Asthma
