• Loren W Hunt, Evangelo Frigas, Joseph H Butterfield, Hirohito Kita, Judith Blomgren, Sandra L Dunnette, Kenneth P Offord, and Gerald J Gleich.
• Department of Internal Medicine, Division of Allergic Diseases, Mayo Clinic and Foundation, Mayo Graduate School of Medicine, Rochester, MN 55905, USA.
• J. Allergy Clin. Immunol. 2004 May 1;113(5):853-9.

BackgroundIn 2 prior uncontrolled studies, nebulized lidocaine reduced oral glucocorticoid use in patients with severe glucocorticoid-dependent asthma.ObjectiveWe tested the safety and efficacy of nebulized lidocaine in a randomized, placebo-controlled study in patients with mild-to-moderate asthma.MethodsWe recruited 50 subjects (25 receiving lidocaine and 25 receiving placebo); all had a prebronchodilator FEV(1) of 64% to 125% of predicted normal value and were treated with daily inhaled glucocorticoids (but not systemic glucocorticoids) and bronchodilators for at least 2 months. Before treatment, subjects monitored their symptoms and peak flow values and maintained their medications for 2 weeks. At initiation, subjects inhaled either nebulized placebo (saline) or lidocaine (4%, 100 mg) 4 times daily. All subjects were instructed to reduce their inhaled glucocorticoid dosage by one half each week for 3 weeks and to discontinue glucocorticoid treatment at week 4. The subjects continued the nebulized lidocaine or placebo for a total of 8 weeks, monitored their symptoms, and used bronchodilators to control symptoms.ResultsIndicators of asthma severity showed benefit for the lidocaine-treated group: changes in FEV(1) (P < or =.001), nighttime awakenings (P < or =.02), symptoms (P < or =.010), bronchodilator use (P < or =.010), and blood eosinophil counts (P < or =.020). Subjects in both groups reduced use of inhaled glucocorticoids comparably. Subjects receiving nebulized placebo showed increases in their symptom scores, bronchodilator use (P < or =.05 for both), and blood eosinophil counts (P < or =.01) and decreases in FEV(1) (P < or =.001).ConclusionNebulized lidocaine provided effective and safe therapy in subjects with mild-to-moderate asthma.

25 keywords...

hide…