Randomized trial of inhaled beclomethasone dipropionate versus theophylline for moderate asthma during pregnancy.
OBJECTIVE
This study was undertaken to compare the efficacy of inhaled beclomethasone dipropionate to oral theophylline for the prevention of asthma exacerbation(s) requiring medical intervention.


METHODS
A prospective, double-blind, double placebo-controlled randomized clinical trial of pregnant women with moderate asthma was performed.


RESULTS
There was no significant difference (P=.554) in the proportion of asthma exacerbations among the 194 women in the beclomethasone cohort (18.0%) versus the 191 in the theophylline cohort (20.4%; risk ratio [RR]=0.9, 95% CI=0.6-1.3). The beclomethasone cohort had significantly lower incidences of discontinuing study medications caused by side effects (RR=0.3, 95% CI=0.1-0.9; P=.016), and proportion of study visits with forced expiratory volume expired in 1 second (FEV1) less than 80% predicted (0.284+/-0.331 vs 0.284+/-0.221, P=.039). There were no significant differences in treatment failure, compliance, or proportion of peak expiratory flow rate less than 80% predicted. There were no significant differences in maternal or perinatal outcomes.


CONCLUSIONS
The treatment of moderate asthma with inhaled beclomethasone versus oral theophylline resulted in similar rates of asthma exacerbations and similar obstetric and perinatal outcomes. These results favor the use of inhaled corticosteroids for moderate asthma during pregnancy because of the improved FEV1 and because theophylline had more side effects and requires serum monitoring.
Dombrowski
Mitchell P
MP
Department of Obstetrics and Gynecology, Wayne State University, Detroit, Mich, USA. Mitchell.Dombrowski@stjohn.org
Schatz
Michael
M
Wise
Robert
R
Thom
Elizabeth A
EA
Landon
Mark
M
Mabie
William
W
Newman
Roger B
RB
McNellis
Donald
D
Hauth
John C
JC
Lindheimer
Marshall
M
Caritis
Steve N
SN
Leveno
Kenneth J
KJ
Meis
Paul
P
Miodovnik
Menachem
M
Wapner
Ronald J
RJ
Varner
Michael W
MW
O'Sullivan
Mary Jo
MJ
Conway
Deborah L
DL
D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001507:Beclomethasone / Q000008:administration & dosage* / Q000009:adverse effects; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D013806:Theophylline / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D013806:Theophylline; D001507:Beclomethasone