title: Improvement of asthma control with beclomethasone extrafine aerosol compared to fluticasone and budesonide.
abstract: Qvar Autohaler efficacy on asthma control, assessed with E. Juniper asthma control questionnaire (ACQ), was compared with fluticasone and budesonide. An open randomized study, stratified (2:1) on the intake of long-acting beta2-mimetics (LAbeta2), was performed in patients with moderate to severe poorly controlled asthma (defined by at least one nocturnal discomfort in the last 5 days or a mean of 2 puffs of short-acting beta2-mimetics in the last 7 days or exercise dyspnea) despite treatment with beclomethasone < or = 1000 microg/day (or equivalent). 460 patients received Qvar Autohaler 800 microg/day (n = 149), fluticasone Diskus 1000 microg/day (n = 149) or budesonide Turbuhaler 1600 microg/day (n = 162) during 12 weeks. Asthma control improved in all groups, with no difference between groups. For patients treated with LAbeta2 (n = 286) a significantly greater improvement of the ACQ score was obtained with Qvar Autohaler versus fluticasone (1.0 +/- 1.0 vs. 0.6 +/- 0.9; P = 0.019), but not versus budesonide (0.9 +/- 0.9). Pulmonary function test improvements were similar in the 3 groups. The significant improvement in asthma control in patients receiving LAbeta2 suggests potential advantages for extrafine aerosols as part of anti-inflammatory treatment optimization.
authors.affiliation: CHU Pellegrin, Place Amélie Raba Léon, F-33000, Bordeaux, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Molimard
authors.forename: Yan
authors.initials: Y
authors.lastname: Martinat
authors.forename: Yves
authors.initials: Y
authors.lastname: Rogeaux
authors.forename: Dominique
authors.initials: D
authors.lastname: Moyse
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Pello
authors.forename: Violaine
authors.initials: V
authors.lastname: Giraud
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000336:Aerosols; D000420:Albuterol / Q000031:analogs & derivatives / Q000627:therapeutic use; D000730:Androstadienes / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001507:Beclomethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000627:therapeutic use; D005260:Female; D000068298:Fluticasone; D000068759:Formoterol Fumarate; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D008297:Male; D036501:Metered Dose Inhalers; D008875:Middle Aged; D010316:Particle Size; D010366:Peak Expiratory Flow Rate; D012129:Respiratory Function Tests; D000068299:Salmeterol Xinafoate
chemical_list: D000336:Aerosols; D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D004983:Ethanolamines; D020024:Leukotriene Antagonists; D019819:Budesonide; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D001507:Beclomethasone; D000420:Albuterol; D000068759:Formoterol Fumarate