Usefulness of HFA-BDP for adult patients with bronchial asthma: randomized crossover study with fluticasone.
In this randomized crossover study, 22 adult patients with moderate-to-severe persistent bronchial asthma were assigned to one of two groups. Patients in group 1 were administered fluticasone dry powder inhaler (DPI) for 8 weeks followed by a 2-week washout period, then hydrofluoroalkane-beclometasone dipropionate (HFA-BDP) for 8 weeks. After a further 2-week washout, they were again administered fluticasone DPI for 8 weeks. Patients in group 2 were assigned HFA-BDP followed by fluticasone PII and finally HFA-BDP over the same time periods. In both groups, no significant difference was observed in use of beta2-agonists and symptom score between the treatment periods; however, markers of pulmonary function were significantly higher when on HFA-BDP versus fluticasone DPI. Significant increases of morning peak expiratory flow (PEF) (p < 0.01), forced expiratory volume in 1 second (FEV1.0) (p < 0.01), V50 (p < 0.05), and V25 (p < 0.01) were observed at 18 weeks in group 1, whereas there were significant decreases of V50 (p < 0.05) at 18 weeks in group 2. No significant difference was noted in circulating eosinophil count and serum ECP between the 2 treatments; however, ECP in induced sputum and nitric oxide in expired gas were significantly lower (p < 0.05 and < 0.01, respectively) when on HFA-BDP versus fluticasone DPI. HFA-BDP might be delivered to small airways more effectively than fluticasone DPI.
Horiguchi
Takahiko
T
Department of Respiratory Medicine, Second Teaching Hospital, Fujita Health University School of Medicine, Nagoya, Aichi, Japan. kokyu-2@fujita-hu.ac.jp
Hayashi
Nobuyuki
N
Ohira
Daisuke
D
Torigoe
Hiroshi
H
Ito
Tomohiro
T
Hirose
Masahiro
M
Sasaki
Yasushi
Y
Shiga
Mamoru
M
Miyazaki
Junichi
J
Kondo
Rieko
R
Tachikawa
Soichi
S
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000335:Aerosol Propellants; D000730:Androstadienes / Q000009:adverse effects / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000009:adverse effects / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008499:Medical Records; D036501:Metered Dose Inhalers; D008875:Middle Aged; D010316:Particle Size; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D005466:Fluorocarbons
D000318:Adrenergic beta-Agonists; D000335:Aerosol Propellants; D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D001507:Beclomethasone; D001993:Bronchodilator Agents; D004338:Drug Combinations; D000068298:Fluticasone; D006845:Hydrocarbons, Fluorinated; C094049:apaflurane; D005466:Fluorocarbons