Bronchodilatory Effect of the PPAR-γ Agonist Rosiglitazone in Smokers With Asthma

Smokers with asthma show a reduced response to inhaled corticosteroids. We hypothesized that a peroxisome proliferator–activated receptor-γ (PPAR-γ) agonist would be superior for the clinical treatment of these asthma patients. Forty-six smokers with asthma were randomized to inhaled beclometasone dipropionate (200 µg per day) or rosiglitazone (8 mg per day) for 4 weeks. Rosiglitazone produced improvements in lung function (forced expiratory volume in 1 s (FEV1) = 183 ml, P = 0.051; forced expiratory flow between 25 and 75% of the forced vital capacity (FEF25–75) = 0.24 l/s, P = 0.030) as compared with inhaled beclometasone dipropionate. Further trials using PPAR-γ agonists in steroid-resistant airway disease are indicated. Clinical Pharmacology & Therapeutics (2009); 86, 1, 49–53 doi:10.1038/clpt.2009.41