Treatment of exercise-induced asthma with beclomethasone dipropionate in children with asthma.
A new hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) aerosol markedly increases drug delivery to the airways. Therefore, even low doses of HFA-BDP should be effective, and the present study assesses this. A randomised, double-blind, crossover study was used to compare the effect of placebo, HFA-BDP 50 microg or 100 microg given q.d. (QVAR(TM) Autohaler(TM); 3M Pharmaceuticals, St. Paul, MN, USA) on exercise-induced bronchoconstriction and exhaled nitric oxide (eNO). After a 14-day run-in, 25 children (5-14 yrs old) entered three 4-week treatment periods, separated by a 1-week washout. After each period, the fall in forced expiratory volume in one second (FEV1), after an exercise test, and eNO were measured. Significant treatment effects with no carry-over or period effects were seen for both eNO and maximum fall in FEV1 after exercise. Differences were seen between placebo (fall in FEV1=27.9%; eNO=14.4 parts per billion (ppb)) and either dose of HFA-BDP, but not between the two active doses (50 microg: fall in FEV1=20.8%, eNO=9.3 ppb; 100 microg: fall in FEV1=20.9%, eNO=8.9 ppb). In conclusion, low q.d. doses of hydrofluoroalkane-beclomethasone dipropionate reduced exhaled nitric oxide and exercise-induced bronchoconstriction. Further studies are needed to assess whether q.d. administration of beclomethasone dipropionate is as effective as b.i.d. administration.
Petersen
R
R
Dept of Paediatrics, Kolding Hospital, 6000 Kolding, Denmark. sumsar68@hotmail.com
Agertoft
L
L
Pedersen
S
S
D000280:Administration, Inhalation; D000293:Adolescent; D000335:Aerosol Propellants / Q000627:therapeutic use; D000336:Aerosols; D000704:Analysis of Variance; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D019540:Area Under Curve; D001250:Asthma, Exercise-Induced / Q000188:drug therapy*; D001507:Beclomethasone / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003718:Denmark; D004311:Double-Blind Method; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000627:therapeutic use; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D012129:Respiratory Function Tests; D016896:Treatment Outcome
D000335:Aerosol Propellants; D000336:Aerosols; D018927:Anti-Asthmatic Agents; D006845:Hydrocarbons, Fluorinated; D009569:Nitric Oxide; D001507:Beclomethasone