A methodological assessment of diurnal variability of peak flow as a basis for comparing different inhaled steroid formulations John H. Toogood, MD,

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Presentation transcript:

A methodological assessment of diurnal variability of peak flow as a basis for comparing different inhaled steroid formulations John H. Toogood, MD, FRCPCa,b, Pantelis Andreou, MA, MScc, Jon Baskerville, PhDc Journal of Allergy and Clinical Immunology Volume 98, Issue 3, Pages 555-562 (September 1996) DOI: 10.1016/S0091-6749(96)70089-1 Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 1 Deviations from the threshold level of LPF (open circles) and DVPF (filled circles), for three representative patients, indicating a statistically significant deterioration in asthma control relative to baseline state. Given the formulas used to calculate the occurrence of asthma relapse as described in Methods, downward deviation indicates either a decrease in LPF or an increase in DVPF. Weeks of use of test treatments are shown on the abscissa. The first value that signifies advent of an asthma relapse is indicated by the arrowhead. The changes in LPF and DVPF observed in this study were not concordant in some patients. Journal of Allergy and Clinical Immunology 1996 98, 555-562DOI: (10.1016/S0091-6749(96)70089-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 1 Deviations from the threshold level of LPF (open circles) and DVPF (filled circles), for three representative patients, indicating a statistically significant deterioration in asthma control relative to baseline state. Given the formulas used to calculate the occurrence of asthma relapse as described in Methods, downward deviation indicates either a decrease in LPF or an increase in DVPF. Weeks of use of test treatments are shown on the abscissa. The first value that signifies advent of an asthma relapse is indicated by the arrowhead. The changes in LPF and DVPF observed in this study were not concordant in some patients. Journal of Allergy and Clinical Immunology 1996 98, 555-562DOI: (10.1016/S0091-6749(96)70089-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 1 Deviations from the threshold level of LPF (open circles) and DVPF (filled circles), for three representative patients, indicating a statistically significant deterioration in asthma control relative to baseline state. Given the formulas used to calculate the occurrence of asthma relapse as described in Methods, downward deviation indicates either a decrease in LPF or an increase in DVPF. Weeks of use of test treatments are shown on the abscissa. The first value that signifies advent of an asthma relapse is indicated by the arrowhead. The changes in LPF and DVPF observed in this study were not concordant in some patients. Journal of Allergy and Clinical Immunology 1996 98, 555-562DOI: (10.1016/S0091-6749(96)70089-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 2 Change in LPF and DVPF (shown separately for each patient) from baseline to time of initial asthma relapse, as defined in Methods. Increases in DVPF were not consistently related to a drop in LPF. Journal of Allergy and Clinical Immunology 1996 98, 555-562DOI: (10.1016/S0091-6749(96)70089-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 3 Attrition of each treatment group caused by asthma relapse, as derived from the relapse data for DVPF (A) or LPF (B). LPF discriminated more efficiently than DVPF between active and inactive test treatments (i.e., inhaled budesonide vs placebo or oral budesonide), respectively. Journal of Allergy and Clinical Immunology 1996 98, 555-562DOI: (10.1016/S0091-6749(96)70089-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 3 Attrition of each treatment group caused by asthma relapse, as derived from the relapse data for DVPF (A) or LPF (B). LPF discriminated more efficiently than DVPF between active and inactive test treatments (i.e., inhaled budesonide vs placebo or oral budesonide), respectively. Journal of Allergy and Clinical Immunology 1996 98, 555-562DOI: (10.1016/S0091-6749(96)70089-1) Copyright © 1996 Mosby, Inc. Terms and Conditions