title: A randomized study comparing ciclesonide and fluticasone propionate in patients with moderate persistent asthma.
abstract: OBJECTIVE
  To compare the effects of once-daily ciclesonide and twice-daily fluticasone propionate in patients with moderate persistent asthma.
  
  
  METHODS
  Patients aged 12-75 years with moderate bronchial asthma entered a 1-4 week run-in period. For inclusion into the 12-week, randomized, open-label treatment period, patients had to have a forced expiratory volume in 1s (FEV1) of either 60-80% of predicted or 80% of predicted and a defined use of rescue medication and asthma symptoms, depending on previous treatment. Patients received ciclesonide 320 microg once daily (ex-actuator) or fluticasone propionate 200 microg twice daily. Primary efficacy endpoint was change from baseline in FEV1.
  
  
  RESULTS
  In total, 474 patients were randomized. FEV1 increased significantly from baseline with ciclesonide and fluticasone propionate in the intention-to-treat (ITT) and per-protocol (PP) analyses (all p < 0.0001). Treatment difference was -31 mL (95% confidence interval [CI]: -121, 59) in the PP analysis, demonstrating non-inferiority of ciclesonide. Similar findings were seen for other measures of lung function. In the ITT population, asthma symptom scores and rescue medication use decreased with both treatments (all p < 0.0001). Improvement in health-related quality of life (HRQoL) from baseline was significantly greater with ciclesonide than fluticasone (p = 0.005; one-sided). There were no cases of oral candidiasis in patients receiving ciclesonide and nine cases (3.8%) in those receiving fluticasone propionate (p = 0.002; one-sided).
  
  
  CONCLUSIONS
  Treatment with once-daily ciclesonide and twice-daily fluticasone propionate resulted in similar improvements in lung function in patients with moderate persistent asthma. Ciclesonide showed significant improvements in oral candidiasis and HRQoL over fluticasone.
authors: Institut de cardiologie et de pneumologie de l'Université Laval, Hôpital Laval, 2725 Chemin Sainte-Foy, Québec City, Que., Canada G1V 4G5. lpboulet@med.ulaval.ca
authors: Louis-Philippe
authors: LP
authors: Boulet
authors: Eric D
authors: ED
authors: Bateman
authors: Robert
authors: R
authors: Voves
authors: Thomas
authors: T
authors: Müller
authors: Susanne
authors: S
authors: Wolf
authors: Renate
authors: R
authors: Engelstätter
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000730:Androstadienes / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002648:Child; D004334:Drug Administration Schedule; D005260:Female; D000068298:Fluticasone; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011282:Pregnenediones / Q000008:administration & dosage*; D012129:Respiratory Function Tests
chemical_list: D000730:Androstadienes; D001993:Bronchodilator Agents; D011282:Pregnenediones; D000068298:Fluticasone; C120481:ciclesonide