| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Clinical Trial |
Airway inflammation is now regarded as fundamental in the pathogenesis of asthma and treatment with inhaled corticosteroids has proved effective. There is a need for drugs in this category with higher topical potency but fewer side-effects than those presently available. A double-blind, parallel group study was conducted in 671 patients with severe asthma (already taking between 0.8-2.0 mg of inhaled corticosteroid daily) to compare the safety and efficacy of 6 weeks of treatment with inhaled fluticasone propionate (FP), 1 mg daily, to fluticasone propionate, 2 mg daily, and budesonide (BUD), 1.6 mg daily, delivered via a metered-dose inhaler. Peak expiratory flow (PEF), asthma symptoms, and usage of rescue medication were recorded daily by the patient. At each clinic visit (-2, 0, 3 and 6 weeks) morning serum cortisol levels, bone markers and spirometry were assessed. The changes in mean morning PEF from baseline (weeks 1-6) were: FP 2 mg daily +24 l.min-1; FP 1 mg daily +21 l.min-1; BUD 1.6 mg daily +13 l.min-1. A similar rank order for the three treatments was seen for evening PEF, clinic spirometry, reduction of diurnal PEF variation, symptom scores, and requirement for rescue bronchodilators. The mean serum cortisol levels remained well within the normal range in all three groups. Analysis of the geometric mean cortisol ratio (treatment/baseline ratio after 6 weeks treatment) showed a changed rank order, the values being: FP 1 mg daily 1.04; BUD 1.6 mg daily 0.97; FP 2 mg daily 0.88.(ABSTRACT TRUNCATED AT 250 WORDS)
This article has been cited by other articles:
|
|
 |
|
  M. Masoli, M. Weatherall, S. Holt, P. Shirtcliffe, and R. Beasley Inhaled fluticasone propionate and adrenal effects in adult asthma: systematic review and meta-analysis Eur. Respir. J., November 1, 2006; 28(5): 960 - 967. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. J. Roland, R. K. Bhalla, and J. Earis The Local Side Effects of Inhaled Corticosteroids: Current Understanding and Review of the Literature Chest, July 1, 2004; 126(1): 213 - 219. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Masoli, M Weatherall, S Holt, and R Beasley Clinical dose-response relationship of fluticasone propionate in adults with asthma Thorax, January 1, 2004; 59(1): 16 - 20. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. O'Sullivan, L. Cormican, M. Murphy, L. W. Poulter, and C. M. Burke Effects of Varying Doses of Fluticasone Propionate on the Physiology and Bronchial Wall Immunopathology in Mild-to-Moderate Asthma Chest, December 1, 2002; 122(6): 1966 - 1972. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. D. Lynd, D. P. Guh, P. D. Pare, and A. H. Anis Patterns of Inhaled Asthma Medication Use: A 3-Year Longitudinal Analysis of Prescription Claims Data From British Columbia, Canada Chest, December 1, 2002; 122(6): 1973 - 1981. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Johnell, R. Pauwels, C-G. Lofdahl, L.A. Laitinen, D.S. Postma, N.B. Pride, and S.V. Ohlsson Bone mineral density in patients with chronic obstructive pulmonary disease treated with budesonide Turbuhaler(R) Eur. Respir. J., June 1, 2002; 19(6): 1058 - 1063. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. DelGaudio Steroid Inhaler Laryngitis: Dysphonia Caused by Inhaled Fluticasone Therapy Arch Otolaryngol Head Neck Surg, June 1, 2002; 128(6): 677 - 681. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Holt, A. Suder, M. Weatherall, S. Cheng, P. Shirtcliffe, R. Beasley, and A. Herxheimer Dose-response relation of inhaled fluticasone propionate in adolescents and adults with asthma: meta-analysis Commentary: Dosage needs systematic and critical review BMJ, August 4, 2001; 323(7307): 253 - 253. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T W Harrison, A Wisniewski, J Honour, and A E Tattersfield Comparison of the systemic effects of fluticasone propionate and budesonide given by dry powder inhaler in healthy and asthmatic subjects Thorax, March 1, 2001; 56(3): 186 - 191. [Abstract] [Full Text]
|
|
|
|
 |
|
 L. P. NIELSEN and R. DAHL Therapeutic Ratio of Inhaled Corticosteroids in Adult Asthma . A Dose-Range Comparison between Fluticasone Propionate and Budesonide, Measuring Their Effect on Bronchial Hyperresponsiveness and Adrenal Cortex Function Am. J. Respir. Crit. Care Med., December 1, 2000; 162(6): 2053 - 2057. [Abstract] [Full Text]
|
|
|
|
|
|
J. CHRISTIAN VIRCHOW Jr., A. PRASSE, I. NAYA, L. SUMMERTON, A. HARRIS, and The Zafirlukast Study Group Zafirlukast Improves Asthma Control in Patients Receiving High-Dose Inhaled Corticosteroids Am. J. Respir. Crit. Care Med., August 1, 2000; 162(2): 578 - 585. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A J Fairfax, V David, and G Douce Laryngeal aspergillosis following high dose inhaled fluticasone therapy for asthma Thorax, September 1, 1999; 54(9): 860 - 861. [Abstract] [Full Text]
|
|
|
|
|
|
E. DEROM, J. VAN SCHOOR, W. VERHAEGHE, W. VINCKEN, and R. PAUWELS Systemic Effects of Inhaled Fluticasone Propionate and Budesonide in Adult Patients with Asthma Am. J. Respir. Crit. Care Med., July 1, 1999; 160(1): 157 - 161. [Abstract] [Full Text]
|
|
|
|
 |
|
 B. H. Rowe, G. W. Bota, L. Fabris, S. A. Therrien, R. A. Milner, and J. Jacono Inhaled Budesonide in Addition to Oral Corticosteroids to Prevent Asthma Relapse Following Discharge From the Emergency Department: A Randomized Controlled Trial JAMA, June 9, 1999; 281(22): 2119 - 2126. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Lipworth Systemic Adverse Effects of Inhaled Corticosteroid Therapy: A Systematic Review and Meta-analysis Arch Intern Med, May 10, 1999; 159(9): 941 - 955. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Wales, H. Makker, J. Kane, P. McDowell, and B. R. O'Driscoll Systemic Bioavailability and Potency of High-Dose Inhaled Corticosteroids: A Comparison of Four Inhaler Devices and Three Drugs in Healthy Adult Volunteers Chest, May 1, 1999; 115(5): 1278 - 1284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M Wilson and B. J Lipworth 24 hour and fractionated profiles of adrenocortical activity in asthmatic patients receiving inhaled and intranasal corticosteroids Thorax, January 1, 1999; 54(1): 20 - 26. [Abstract] [Full Text]
|
|
|
|
|
|
P. J. BARNES, S. PEDERSEN, and W. W. BUSSE Efficacy and Safety of Inhaled Corticosteroids . New Developments Am. J. Respir. Crit. Care Med., March 1, 1998; 157(3): S1 - 53. [Full Text] [PDF]
|
|
|
|
|
|
R Donnelly, K. Williams, A. Baker, C. Badcock, R. Day, and J. Seale Effects of budesonide and fluticasone on 24-hour plasma cortisol. A dose-response study Am. J. Respir. Crit. Care Med., December 1, 1997; 156(6): 1746 - 1751. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
