Current asthma medicines include inhalers. A common type of inhaler is called a 'beta-agonist' (e.g. salbutamol). They improve asthma symptoms by stimulating areas in the airway causing it to widen. Although these drugs are useful short term, long term use can make asthma worse in some people. 'Beta-blockers' are the complete opposite type of medication. Just now they are avoided in patients with asthma. Beta-blockers cause problems in asthmatics in the short term, including severe asthma attacks. The other mainstay of inhaler treatment for asthma is inhaled steroid or 'preventer' medication. These work by dampening down the inflammation in the lungs that occurs in asthma. New research has suggested that longer term use of beta-blockers can also reduce airway inflammation which may improve asthma control. This research was done in asthmatic patients who didn't need inhaled steroids to control their asthma. At the moment the investigators are studying to see if there is a benefit of beta-blocker use for asthma over and above asthmatics own usual doses of inhaled steroids. In this study, the investigators will be trying to find out if adding a beta blocker to a smaller dose of steroid inhaler has the same effect on asthma control as just using a higher dose of steroid inhaler by itself.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
16
Propranolol: 10mg bd for 1 week, 20mg bd for 2 weeks, 80mg MR for 4 weeks.
Placebo tablets: 1 tab bd for 2 weeks, 1 tab od for 4 weeks
Qvar 50, 1 puff bd for 6 weeks
Qvar 100, 2 puffs bd for 6 weeks
Asthma and Allergy Research Group, University of Dundee
Dundee, Scotland, United Kingdom
Change in Histamine provocative concentration causing 20% fall in FEV1 (PC20)at 6 weeks
Measurement of airway hyper-reactivity (a hallmark of asthma).
Time frame: Change from baseline to 6 weeks
Change in Impulse oscillometry parameters at 6 weeks
Change in: Resistance at 5Hz, Resistance at 20Hz, Reactance at 5Hz, Frequency of resonance, Area under reactance curve.
Time frame: Change from baseline to 6 weeks
Change in Spirometry parameters at 6 weeks
Change in: Forced expiratory volume in 1 second (FEV1); forced vital capacity (FVC); forced expriatory flow between 25-75% of vital capacity; FEV1/FVC ratio.
Time frame: Change from baseline to 6 weeks
Change in resting heart rate at 6 weeks
Abosolute change in heart rate at 6 weeks will be a secondary outcome. Participants will measure their own heart rate at home on a daily basis and compare this to a given cut-off value, below which they will be advised to contact a trial doctor.
Time frame: Change from baseline to 6 weeks
Change in resting blood pressure at 6 weeks
Blood pressure will be monitored at each visit, or if patients develop symptoms that may be due to low blood pressure.
Time frame: Change from baseline to 6 weeks
Change in exhaled tidal nitric oxide levels at 6 weeks
Time frame: Change from baseline to 6 weeks
Change in overnight urinary cortisol/creatinine ratio (OUCC) at 6 weeks
Systemic effects from inhaled corticosteroids can be measured using OUCC.
Time frame: Change from baseline to 6 weeks
Change in symptom scores (Asthma control questionnaire and Asthma quality of life questionnaire) at 6 weeks
Time frame: Change from baseline to 6 weeks
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.