Doctors had hypothesized that inhaled steroids prescribed for asthma patients might help smokers because both groups suffer shortness of breath. However, two studies in Thursday's New England Journal of Medicine found steroids to be of little help for smokers.
Smoking causes about 85 percent of all cases of chronic obstructive pulmonary disease, which is a combination of chronic bronchitis and emphysema. Nearly 16 million Americans suffer from the disease, according to the American Lung Association.
The Centers for Disease Control and Prevention reported that more than 106,000 people died of the illness in 1996, making it the fourth leading cause of death in the United States.
"The tragedy of all of this is this is almost a wholly preventable disease. The real message is that people should not smoke," said Dr. Dennis E. Niewoehner of the Veterans Affairs Medical Center in Minneapolis.
In one of the studies, conducted by Niewoehner and colleagues at 25 VA medical centers, 80 patients were given an inhaled steroid for eight weeks, 80 received steroids for two weeks and 111 received a placebo.
In both groups that received treatment, the steroids were associated with shorter hospital stays and easier breathing at the beginning, but the benefits were no longer evident after six months, and the eight-week treatment was found to be no more effective than two weeks of treatment.
What's more, compared with patients who got a placebo, those who were treated with steroids were more likely to require treatment for hyperglycemia, an abnormally high level of sugar in the blood.
In the other study, from Dr. Romain A. Pauwels of University Hospital in Ghent, Belgium, and colleagues, an inhaled steroid was tested on patients who refused to stop smoking and suffered from a milder form of lung disease. The medicine was found to produce a one-time improvement in lung function, but it had no appreciable effect over the long term.
In an editorial, Dr. Homer A. Boushey of the University of California at San Francisco said the studies prove that inflammation in the airways in asthma patients is markedly different from that suffered by smokers.
Written By Brigitte Greenberg