Nebulized lidocaine in mild-moderate asthma

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Previous uncontrolled studies have reported dramatic responses to inhaled lidocaine in a high percentage of adults and children with severe asthma. In this issue of the Journal, Hunt and coworkers (p 853) report the results of a placebo-controlled, 8-week study in 50 adult subjects with asthma. All subjects were using inhaled but not systemic corticosteroids. After randomization to either placebo or inhaled lidocaine 4 times daily, their inhaled steroids were withdrawn, stepwise, over 4 weeks. Similar numbers in each group remained in the study at 4 and 8 weeks. Reasons for withdrawal included worsening asthma (4 on lidocaine and 6 on placebo) and treatment intolerance (4 on lidocaine). Intent-to-treat analysis revealed a significant benefit for lidocaine treatment compared with placebo for FEV₁ symptom scores, nighttime awakening, β-agonist use, and blood eosinophils. There were no serious adverse effects in either group. The authors conclude that nebulized lidocaine provided effective and safe therapy in subject with mild to moderate asthma.

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• Changes in asthma severity in the lidocaine and placebo groups.