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BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7501.1174 (Published 19 May 2005) Cite this as: BMJ 2005;330:1174
  1. Harvey Marcovitch, BMJ syndication editor (h.marcovitch@btinternet.com)

    Smokers with asthma are resistant to inhaled steroids

    Smokers with asthma respond poorly to standard doses of inhaled steroids and may require a higher dose regime than is usually recommended. In a multicentre randomised trial of 400 μg of beclomethasone daily for 12 weeks, smokers showed little change in markers of asthma severity compared with the (expected) improvement in non-smokers. They had six times as many exacerbations. At a dose of 2000 μg daily, smokers did improve in terms of simple lung function tests and a reduction in reliever inhaler usage, but non-smokers still had better results. The authors say that their findings are consistent with relative corticosteroid insensitivity in smokers, and they advise encouraging people with asthma not to smoke, as well as considering alternative or additional anti-inflammatory drug treatment.

    Thorax 2005;60: 282-7


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