The comparative safety/efficacy ratio of HFA-BDP.
As has been discussed in the previous sections of the Supplement, the improved physical characteristics of HFA-BDP extrafine aerosol spray allow BDP to be delivered more efficiently into the large, medium and small airways. This improved delivery has allowed the dose of HFA-BDP to be reduced compared to CFC-BDP and budesonide, whilst maintaining equipotency with fluticasone. However, unlike fluticasone, HFA-BDP does not show a propensity for blood or tissue accumulation when administered with a 12-h dosing interval. Standard tests for assessing effects on the HPA-axis indicate that HFA-BDP extrafine aerosol has a favourable systemic bioactivity profile. Even up to the recommended dose of 800 microg day(-1) HFA-BDP (the highest recommended maximum dose), there appear to be no clinically relevant systemic side effects associated with HFA-BDP (Fig. 8). Thus, viewing the data as a whole, it would seem that, compared to CFC-BDP and alternative inhaled corticosteroids, HFA-BDP in a dose of up to 800 microg day(-1) exhibits a favourable therapeutic ratio.
Lipworth
B J
BJ
Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, UK. b.j.lipworth@dundee.ac.uk
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