title: Fluticasone propionate aerosol is more effective for prevention than treatment of recurrent airway obstruction.
abstract: BACKGROUND
  Efficacy of inhaled fluticasone propionate (FP) for management of recurrent airway obstruction (RAO) has only been evaluated after several weeks' treatment.
  
  
  OBJECTIVE
  To compare efficacy of (1) 3-day treatments with FP to dexamethasone (DEX) for management of RAO; and (2) FP and DEX to no treatment in prevention of acute RAO exacerbations.
  
  
  METHODS
  Nine RAO affected horses.
  
  
  METHODS
  Crossover studies in RAO-affected horses compared (a) 3-day treatment of RAO exacerbation with FP (3 and 6 mg q12h) and DEX (0.1 mg/kg q24h) and (b) FP (6 mg q12h) and DEX (0.1 mg/kg q24h) to no treatment for prevention of acute exacerbations of RAO. Treatment efficacy and unwanted effects were judged from maximal change in pleural pressure (DeltaPpl(max)), serum cortisol (COR), bronchoalveolar lavage (BAL) cytology, and subjective scores for respiratory distress and lameness.
  
  
  RESULTS
  In treatment trial, DEX and FP (6 mg) significantly decreased DeltaPpl(max) by 48 and 72 hours, respectively; FP (3 mg) had no significant effect. DEX decreased COR more than did FP. In prevention trial, both DEX and FP (6 mg) prevented the increase in DeltaPpl(max) that occurred in untreated horses. Both treatments decreased COR to the same degree. FP and DEX had no effects on bronchoalveolar lavage fluid (BALF) cytology and there was no evidence of laminitis.
  
  
  CONCLUSIONS
  FP (6 mg q12h) is as effective as DEX for prevention of acute exacerbations of RAO and lower doses should be evaluated. High-dose FP is not as effective as DEX for treatment of RAO exacerbations.
authors.affiliation: Equine Pulmonary Laboratory, Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824, USA. robinson@cvm.msu.edu
authors.forename: N E
authors.initials: NE
authors.lastname: Robinson
authors.forename: C
authors.initials: C
authors.lastname: Berney
authors.forename: A
authors.initials: A
authors.lastname: Behan
authors.forename: F J
authors.initials: FJ
authors.lastname: Derksen
mesh_terms: D000336:Aerosols; D000730:Androstadienes / Q000008:administration & dosage* / Q000627:therapeutic use*; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D000068298:Fluticasone; D006734:Horse Diseases / Q000188:drug therapy*; D006736:Horses; D008173:Lung Diseases, Obstructive / Q000188:drug therapy / Q000662:veterinary*
chemical_list: D000336:Aerosols; D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D000068298:Fluticasone