Airway and systemic effects of hydrofluoroalkane fluticasone and beclomethasone in patients with asthma. Issue 10 (1st October 2002)

• Record Type: Journal Article
• Authors: Currie, G P; Fowler, S J; Wilson, A M; Sims, E J; Orr, L C; Lipworth, B J
• Is Part Of: Thorax. Volume 57:Issue 10(2002)
• Page Start: 865
• Page End: 868
• Publication Date: 2002-10-01
• Subjects: asthma -- hydrofluoroalkane-134a -- fluticasone -- beclomethasone; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax.57.10.865
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: With the transition to hydrofluoroalkane-134a propellants in metered dose inhalers, it is important to consider the efficacy and safety profiles of formulations containing inhaled corticosteroids. We examined the airway and systemic effects of hydrofluoroalkane-134a fluticasone propionate (FLU-HFA) and beclomethasone dipropionate (BEC-HFA) at recommended labelled doses. Methods: Twenty mild to moderate asthmatics were randomised in crossover fashion to receive 6 weeks of 500 μg/day followed by 1000 μg/day FLU-HFA and BEC-HFA. Measurements were made at baseline after placebo run in and washout, and after each randomised treatment. The primary airway outcome for benefit was the dose of methacholine provoking a fall in forced expiratory volume in 1 second (FEV1 ) of 20% or more (methacholine PD20 ) and for systemic adverse effects was overnight urinary cortisol/creatinine (OUCC). Results: For mean responses, both doses of BEC-HFA and FLU-HFA produced significant improvements in PD20 compared with baseline. The improvement was not significantly greater with 1000 μg/day FLU-HFA versus BEC-HFA, a 1.69 fold difference (95% CI 0.94 to 3.04). Both doses of BEC-HFA but not FLU-HFA caused significant suppression of OUCC compared with baseline, with significantly (p<0.05) lower values at 1000 μg/day for BEC-HFA versus FLU-HFA (1.97 fold difference (95% CI 1.28 to 3.02)). Conclusion: There was no difference in the airway and systemic effects in patients with mild to moderate asthma between FLU-HFA and BEC-HFA at a dose of 500 μg/day. At 1000 μg/day there was increased systemic bioactivity with BEC-HFA compared with FLU-HFA, without any gain in airway efficacy.