title: Inhaled mometasone furoate reduces oral prednisone requirements while improving respiratory function and health-related quality of life in patients with severe persistent asthma.
abstract: BACKGROUND
  Inhaled corticosteroid therapy in severe persistent asthma has been shown to reduce or eliminate oral corticosteroid (OCS) use while retaining effective asthma control.
  
  
  OBJECTIVE
  We sought to evaluate the ability of mometasone furoate (MF) delivered by means of dry powder inhaler to reduce daily oral prednisone requirements in OCS-dependent patients with severe persistent asthma.
  
  
  METHODS
  We performed a 12-week, double-blind, placebocontrolled trial (21 centers, 132 patients) comparing 2 doses of MF (400 and 800 microg administered twice daily) with placebo, followed by a 9-month open-label phase in which 128 patients received treatment with MF.
  
  
  RESULTS
  At the endpoint of the double-blind trial, MF 400 and 800 mg twice daily reduced daily OCS requirements by 46.0% and 23.9%, respectively, whereas placebo increased OCS requirements by 164.4% (P <.01). Oral steroids were eliminated in 40%, 37%, and 0% of patients in the MF 400 and 800 mg twice daily and placebo groups, respectively. Pulmonary function and quality of life significantly increased for MF-treated patients. Further reductions in OCS requirements were achieved with long-term MF treatment in the open-label phase.
  
  
  CONCLUSIONS
  MF inhaled orally as a dry powder is an effective alternative to systemic corticosteroids in patients with severe persistent asthma.
authors.affiliation: Department of Pulmonary Medicine, Thomas Jefferson Hospital, Philadelphia, PA, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Fish
authors.forename: J P
authors.initials: JP
authors.lastname: Karpel
authors.forename: T J
authors.initials: TJ
authors.lastname: Craig
authors.forename: G W
authors.initials: GW
authors.lastname: Bensch
authors.forename: M
authors.initials: M
authors.lastname: Noonan
authors.forename: D R
authors.initials: DR
authors.lastname: Webb
authors.forename: B
authors.initials: B
authors.lastname: Silverman
authors.forename: E J
authors.initials: EJ
authors.lastname: Schenkel
authors.forename: A R
authors.initials: AR
authors.lastname: Rooklin
authors.forename: J W
authors.initials: JW
authors.lastname: Ramsdell
authors.forename: R
authors.initials: R
authors.lastname: Nathan
authors.forename: J G
authors.initials: JG
authors.lastname: Leflein
authors.forename: J
authors.initials: J
authors.lastname: Grossman
authors.forename: D F
authors.initials: DF
authors.lastname: Graft
authors.forename: R G
authors.initials: RG
authors.lastname: Gower
authors.forename: S M
authors.initials: SM
authors.lastname: Garay
authors.forename: E
authors.initials: E
authors.lastname: Frigas
authors.forename: A C
authors.initials: AC
authors.lastname: Degraff
authors.forename: E A
authors.initials: EA
authors.lastname: Bronsky
authors.forename: D I
authors.initials: DI
authors.lastname: Bernstein
authors.forename: W
authors.initials: W
authors.lastname: Berger
authors.forename: L
authors.initials: L
authors.lastname: Shneyer
authors.forename: K B
authors.initials: KB
authors.lastname: Nolop
authors.forename: J E
authors.initials: JE
authors.lastname: Harrison
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D003257:Consumer Product Safety; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D011244:Pregnadienediols / Q000008:administration & dosage / Q000627:therapeutic use*; D011788:Quality of Life; D012129:Respiratory Function Tests
chemical_list: D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D011241:Prednisone