Comparison of the anti-inflammatory effects of extra-fine hydrofluoroalkane-beclomethasone vs fluticasone dry powder inhaler on exhaled inflammatory markers in childhood asthma.
BACKGROUND
Extra-fine hydrofluoroalkane-beclomethasone differs from other inhaled corticosteroids by its fine aerosol characteristics. Therefore, extra-fine hydrofluoroalkane-beclomethasone may be particularly useful for treating peripheral airway inflammation in asthma.


OBJECTIVE
To analyze the anti-inflammatory effects of extra-fine hydrofluoroalkane-beclomethasone vs fluticasone dry powder inhaler (DPI) in asthmatic children by measuring bronchial and alveolar nitric oxide (NO) and inflammatory markers in exhaled breath condensate (EBC).


METHODS
In a 6-month crossover study, 33 children aged 6 to 12 years with moderate persistent asthma were randomly treated with extra-fine hydrofluoroalkane-beclomethasone (200 microg daily via an Autohaler) and fluticasone DPI (200 microg daily via a Diskus). The primary outcome variables were alveolar NO concentration and bronchial NO flux. The secondary outcome variables were levels of inflammatory markers in EBC, lung function indices, symptoms, exacerbations, and adverse effects. All the variables were recorded at baseline and after each treatment period.


RESULTS
Mean +/- SE alveolar NO concentration and bronchial NO flux were comparable after treatment with hydrofluoroalkane-beclomethasone vs fluticasone DPI (4.7 +/- 0.5 vs 4.3 +/- 0.5 ppb, P = .55, and 1,124.3 +/- 253.6 vs 1,029.1 +/- 195.5 pL/s, P = .70, respectively). In addition, levels of inflammatory markers in EBC, lung function indices, and symptoms did not differ between treatments. Patients used fewer beta2-agonists during the last 2 weeks of hydrofluoroalkane-beclomethasone treatment.


CONCLUSIONS
The anti-inflammatory effects of hydrofluoroalkane-beclomethasone are similar to those of fluticasone DPI in children with moderate persistent asthma.
Robroeks
Charlotte M H H T
CM
Department of Paediatric Pulmonology, University Hospital Maastricht, Maastricht, The Netherlands. crob@paed.azm.nl
van de Kant
Kim D G
KD
van Vliet
Dillys
D
Kester
Arnold D
AD
Hendriks
Han J E
HJ
Damoiseaux
Jan G M C
JG
Wodzig
Will K W H
WK
Rijkers
Ger T
GT
Dompeling
Edward
E
Jöbsis
Quirijn
Q
D000280:Administration, Inhalation; D000730:Androstadienes / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D001507:Beclomethasone / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001944:Breath Tests; D002648:Child; D018592:Cross-Over Studies; D015237:Dinoprost / Q000031:analogs & derivatives / Q000032:analysis / Q000378:metabolism; D005260:Female; D000068298:Fluticasone; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000737:chemistry; D006861:Hydrogen Peroxide / Q000032:analysis / Q000378:metabolism; D007249:Inflammation / Q000188:drug therapy / Q000378:metabolism; D007378:Interleukins / Q000032:analysis / Q000378:metabolism; D008297:Male; D009566:Nitrates / Q000032:analysis / Q000378:metabolism; D009569:Nitric Oxide / Q000032:analysis / Q000378:metabolism; D009573:Nitrites / Q000032:analysis / Q000378:metabolism; D011446:Prospective Studies; D016896:Treatment Outcome; D014797:Vital Capacity / Q000187:drug effects / Q000502:physiology; D005466:Fluorocarbons
D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D001507:Beclomethasone; D015415:Biomarkers; D015237:Dinoprost; D000068298:Fluticasone; D006845:Hydrocarbons, Fluorinated; D006861:Hydrogen Peroxide; D007378:Interleukins; D009566:Nitrates; D009569:Nitric Oxide; D009573:Nitrites; C075750:8-epi-prostaglandin F2alpha; C094049:apaflurane; D005466:Fluorocarbons