The efficacy and safety of QVAR (hydrofluoroalkane-beclometasone diproprionate extrafine aerosol) in asthma (part 1): an update of clinical experience in adults.
In 1999, a robust dose-finding study showed that the chlorofluorocarbon (CFC) -free formulation of beclometasone dipropionate (BDP), QVAR (hydrofluoroalkane-134a BDP), produced equivalent asthma control to CFC-BDP at approximately half the daily dose in adults. Since then, a wealth of clinical and pharmaco-vigilance studies have been undertaken to confirm these results and establish dose-potency ratios with other inhaled corticosteroids (ICS). This review summarises the results of studies performed by the manufacturer that have been published since the last comprehensive review of the efficacy and safety of QVAR in 2000. Long-term comparisons with CFC-BDP have confirmed the durability of the 2:1 daily dosing ratio of CFC-BDP:QVAR in adults. Clinical comparisons with other ICS in both symptomatic and asymptomatic patients have established dose-potency ratios of 2: 1 for budesonide:QVAR and 1:1 for fluticasone:QVAR. Furthermore, QVAR has been associated with benefits on asthma symptomatology and quality of life, compared with other ICS that probably arises from its peripheral deposition in the lung.
Van Schayck
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Care and Public Health Research Institute, Maastricht, The Netherlands. o.vanschayck@caphri.unimaas.nl
Donnell
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D000328:Adult; D000730:Androstadienes / Q000009:adverse effects / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D000068298:Fluticasone; D005541:Forced Expiratory Volume; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000009:adverse effects / Q000627:therapeutic use*; D015337:Multicenter Studies as Topic; D010366:Peak Expiratory Flow Rate; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014797:Vital Capacity; D005466:Fluorocarbons
D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D001507:Beclomethasone; D000068298:Fluticasone; D006845:Hydrocarbons, Fluorinated; C094049:apaflurane; D005466:Fluorocarbons