A randomized, double-blind, double-dummy, parallel-group, multicenter, dose-reduction trial of the minimal effective doses of budesonide and fluticasone dry-powder inhalers in adults with mild to moderate asthma

Kuna, Piotr; Joubert, James R.; Greefhorst, Louis A.P.M.; Magnussen, H

doi:10.1016/s0149-2918(03)80212-6

Cited by 19 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, half the daily dose of FP provided an efficacy equivalent to that of CFC-BDP [21, 22], and the daily dose of FP also provided an efficacy equivalent to that of HFA-BDP [15]. In the dose reduction study by Kuna et al [23], it was reported that the efficacy ratio of FP-DK to BUD-TH was 1:1–1.25. Considering these study results, in our study, HFA-BDP was used at the same dose as BUD in the patients switched from previous treatment with BUD-TH.…”

Section: Discussionmentioning

confidence: 99%

One-Year Evaluation of the Preventative Effect of Hydrofluoroalkane-Beclomethasone Dipropionate on Eosinophilic Inflammation of Asthmatic Peripheral Airways

Ohbayashi

2006

Respiration

View full text Add to dashboard Cite

Background: In asthmatic patients with eosinophilic inflammation of the peripheral airways, appropriate drug delivery to the affected area is required. Objective: It was the aim of this study to assess persistent eosinophilic inflammation of the peripheral airways in asthmatic patients, stabilized by the long-term use of dry powder type inhaled steroids, and to evaluate the clinical efficacy of hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) over 1 year. Methods: Seventy-four outpatients with moderate stable asthma were studied for at least 6 months, 37 treated with fluticasone propionate Diskus® (FP-DK) and 37 with budesonide Turbuhaler® (BUD-TH). The eosinophil count, eosinophil cationic protein (ECP), eotaxin and RANTES levels in 10% hypertonic saline-induced sputum were examined before treatment, as well as 4 weeks, 8 weeks, 6 months and 1 year after switching patients to HFA-BDP. Results: Fifteen patients (40.5%) in the FP-DK group and 12 (32.4%) in the BUD-TH group had eosinophils in induced sputum. The sputum ECP in the eosinophil-positive and the eosinophil-negative groups was 1,510.1 ± 2,009.3 versus 426.6 ± 464.1 µg/l (p = 0.037) in the FP-DK group, and 3,850.0 ± 5,486.2 versus 492.0 ± 1,150.7 µg/l (p = 0.011) in the BUD-TH group, respectively. Four weeks after the switch to HFA-BDP, the number of eosinophil-positive patients decreased in both groups. Significant reductions in sputum ECP and eotaxin were observed at 8 weeks, and their concentrations continued decreasing for 1 year. Conclusion: There is a certain proportion of asthmatic patients for whom long-term treatment with dry powder type steroids may not be suitable; however, their peripheral airway inflammation improved after switching them to HFA-BDP, suggesting its excellent delivery.

show abstract

Section: Discussionmentioning

confidence: 99%

One-Year Evaluation of the Preventative Effect of Hydrofluoroalkane-Beclomethasone Dipropionate on Eosinophilic Inflammation of Asthmatic Peripheral Airways

Ohbayashi

2006

Respiration

View full text Add to dashboard Cite

show abstract

“…11,14,17 Ninety-seven percent of studies give the mean and 22% give the mean and the range for PEF and/or FEV 1 . 10,20,22,25,30,38,42,45,52,54,57,59,62 Sixty-six percent of studies have mean FEV 1 or PEF between 55 and 80% predicted. Spirometry and PEF measurements alone do not allow classification of patients' asthma severity at baseline because the interpretation of these values depends on such additional parameters as the patients' level of treatment and severity of symptoms.…”

Section: Classification Of Dose-response Studies Based On the Subjectmentioning

confidence: 99%

Dose–response studies of fluticasone propionate and budesonide: Classification based on asthma severity

Mikhak

2006

allergy asthma proc

View full text Add to dashboard Cite

There are discrepancies in the results of dose-response studies of inhaled steroids. Although some studies show a dose-response relationship, others show no change in outcome with increasing the dose of inhaled steroids. These discrepancies are partly caused by the heterogeneity of dose-response studies. One area of heterogeneity is the subjects' level of asthma severity at baseline. The objective of this study was to classify dose-response studies of two widely used inhaled steroids for asthma, fluticasone propionate (FP), and budesonide (BUD), according to the subjects' level of asthma severity at baseline. A PubMed search, limited to the English language and human subjects, was conducted from January of 1983 to January of 2004, using "dose response and budesonide" (331 articles) and "dose-response and fluticasone" (211 articles). Bibliographies of selected articles were searched for more references. Articles with at least two doses of the same inhaled steroid and one objective marker of asthma were included, resulting in 29 articles for FP and 32 articles for BUD. Studies vary widely in their assessment and reporting of indicators of asthma severity and control at baseline but could be classified according to the level of steroid use at baseline as an indicator of asthma severity. Studies with all or some patients on oral steroids at baseline consistently showed a dose response. Although heterogeneity of dose-response studies make their classification and interpretation difficult, a dose response was consistently noted when all or some patients were on oral steroids at baseline.

show abstract

“…In addition, many comparative studies An alternative to comparing the clinical potencies of ICS is to establish the minimum effective maintenance dose (MED) using dose-reduction studies (6,34), although few comparative studies reported to date have used this study design. A second randomized, double-blind, dose-reduction study involving adults with mild to moderate persistent asthma also reported no statistically significant difference in MED between budesonide via Turbuhaler TM and fluticasone propionate via Diskus 1 (39). However, differences in the nominal dose delivered from the respective delivery device were not considered.…”

Section: Clinical Efficacymentioning

confidence: 99%

What Does Potency Actually Mean for Inhaled Corticosteroids?

Williams¹

2005

LJAS

View full text Add to dashboard Cite

A randomized, double-blind, double-dummy, parallel-group, multicenter, dose-reduction trial of the minimal effective doses of budesonide and fluticasone dry-powder inhalers in adults with mild to moderate asthma

Cited by 19 publications

References 12 publications

One-Year Evaluation of the Preventative Effect of Hydrofluoroalkane-Beclomethasone Dipropionate on Eosinophilic Inflammation of Asthmatic Peripheral Airways

One-Year Evaluation of the Preventative Effect of Hydrofluoroalkane-Beclomethasone Dipropionate on Eosinophilic Inflammation of Asthmatic Peripheral Airways

Dose–response studies of fluticasone propionate and budesonide: Classification based on asthma severity

What Does Potency Actually Mean for Inhaled Corticosteroids?

Contact Info

Product

Resources

About