Use of mometasone furoate administered via a dry powder inhaler in the treatment of asthma.
BACKGROUND
Inhaled corticosteroids (ICSs) are effective controller medications that treat the chronic inflammation of asthma. The goal of asthma treatment is to improve lung function, symptoms, and the ability to perform daily activities, while decreasing the risk of exacerbations. Mometasone furoate delivered via a dry powder inhaler (MF-DPI) is indicated for once-daily maintenance treatment of asthma in patients as young as 4 years old.


OBJECTIVE
To review the quality of evidence for the clinical efficacy and safety of MF-DPI in both adults and children in the context of grading systems for guideline recommendations. Publications were identified by searching PubMed (MEDLINE) for 'mometasone furoate AND dry powder inhaler AND asthma' in any field with search limits for publications from 1 January 1995 to 1 August 2008.


RESULTS
MF-DPI has been evaluated in 21 randomized, double-blind, active- or placebo-controlled trials in adults with asthma. Clinical trials investigating the efficacy in patients previously treated with only short-acting beta(2)-agonists, other ICSs, or oral corticosteroids revealed that MF-DPI is efficacious in these populations. The results of a pooled analysis of ten trials and individual results of three long-term safety trials indicate that MF-DPI is well-tolerated with minimal adverse events. Six clinical trials of MF-DPI have been completed in children. Studies of pediatric patients treated with approved doses of MF-DPI indicate that children previously maintained on twice-daily treatment of other ICSs showed improvements in lung function, health-related quality of life, and rescue medication use. In addition, there is no effect on growth velocity or the hypothalamic-pituitary-adrenal axis. In both adults and children, once-daily dosing of MF-DPI has been demonstrated to be as efficacious as twice-daily dosing.


CONCLUSIONS
The findings of this single-database review are that once-daily MF-DPI is efficacious and safe in both adults and children with asthma.
Zeidler
Michelle
M
David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Corren
Jonathan
J
Tashkin
Donald P
DP
D000280:Administration, Inhalation; D000293:Adolescent; D018926:Anti-Allergic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D000068656:Mometasone Furoate; D009330:Nebulizers and Vaporizers; D011244:Pregnadienediols / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D018926:Anti-Allergic Agents; D011244:Pregnadienediols; D000068656:Mometasone Furoate