Inhaled mometasone furoate reduces oral prednisone requirements while improving respiratory function and health-related quality of life in patients with severe persistent asthma.
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.
Fish
J E
JE
Department of Pulmonary Medicine, Thomas Jefferson Hospital, Philadelphia, PA, USA.
Karpel
J P
JP
Craig
T J
TJ
Bensch
G W
GW
Noonan
M
M
Webb
D R
DR
Silverman
B
B
Schenkel
E J
EJ
Rooklin
A R
AR
Ramsdell
J W
JW
Nathan
R
R
Leflein
J G
JG
Grossman
J
J
Graft
D F
DF
Gower
R G
RG
Garay
S M
SM
Frigas
E
E
Degraff
A C
AC
Bronsky
E A
EA
Bernstein
D I
DI
Berger
W
W
Shneyer
L
L
Nolop
K B
KB
Harrison
J E
JE
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
D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D011241:Prednisone