[Dose-effect relation of inhalation steroids in asthma should be paid attention to. Comment to a Cochrane report].
The Cochrane collaboration has performed a meta-analysis of all studies found on the dose-effect relation with beclomethasone dipropionate (BDP) in the treatment of asthma. Fifteen studies were found and included, of which only two comprised children. Daily doses of 100 to 2000 micrograms were used. A two-fold increased dose was used in 9 studies but only few significant improvements were seen with the higher dose. A four- to fivefold increased dose gave significant improvement in one of two studies with an improvement of FEV1 of 16% versus 7% with the lower dose. The dose-effect of BDP seems to be very flat and a four-fold increase of the dose seems more reasonable than the two-fold commonly used today, when improved effect is desired. This increases the risk of side effects, and for long-term therapy other alternatives should be considered.
Foucard
Tony
T
Barnmedicinska kliniken, Akademiska barnsjukhuset, Uppsala.
Skoogh
Bengt-Eric
BE
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008176:Lung Volume Measurements; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic
D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D001507:Beclomethasone