Study of fluticasone propionate efficacy in the treatment of patients with bronchial asthma not controlled by other inhaled corticosteroids.
The aim of the study was to test the fluticasone propionate (FP) efficacy in the treatment of patients with bronchial asthma (BA), not controlled by high doses (more than 1 mg) of other inhaled corticosteroids. Asthma symptoms (degree of dyspnea on Sadoul scale, percentage of symptom-free days and nights), and drug consumption were measured and lung function tests were performed in 20 patients (11 women and 9 men, mean age 47 years) for a 2 months period. Biochemical measurements were done referring to oxidant/antioxidant imbalance, which is characteristic to inflammatory diseases of respiratory system. We evaluated lipoperoxidation (LPO) in the plasma and the blood, before and after FP treatment, by determining malondialdehyde (MDA) status, superoxide-dismutase and ceruloplasmine activity and non-protein SH groups (essential glutathione) status. The biochemical measurements showed a significant decrease in lipid peroxides level in the plasma and the blood and a slight increase of glutathione after 2 months treatment with FP. Lung function tests were performed on a Flow Streen Jaeger and we determined: peak expiratory flow (PEF), vital capacity (VC), forced expiratory volume in 1 sec. (FEV1) and mid-expiratory flow at 50% VC (MEF50). The measurements were done before FP administration, after 3 days, 7 days, 1 month and 2 months. The dose of FP was equivalent to 50-75% of the daily dose of Beclomethasone dipropionate (BD) previously administered. The degree of dyspnea diminished from 3-4 to 0-1. The percentage of symptom-free days and nights improved from 12% to 78% and 25% to 95% respectively. The use of short acting beta agonists diminished with 75% and no patients required i.v. corticotherapy or theophylline. PEF increased with a mean of 25%, VC with a mean of 23%, FEV1 with a mean of 30% and MEF50 with a mean of 36%. Our results demonstrate improved efficacy of FP vs high doses of other inhaled corticosteroids in the treatment of moderate persistent and severe forms of BA.
Leru
P
P
N. Gh. Lupu Clinical Hospital, Bucharest, Romania.
Rascu
A
A
Oţelea
M
M
Mohora
M
M
Muscurel
C
C
Gâlcă
M
M
Dinu
V
V
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000730:Androstadienes / Q000008:administration & dosage*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests / Q000706:statistics & numerical data
D000305:Adrenal Cortex Hormones; D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D000068298:Fluticasone