Beclomethasone/formoterol fixed combination for the management of asthma: patient considerations

Nicolini, Gabriele; Scichilone, Nicola; Papi, Alberto; Fabbri, Leonardo

doi:10.2147/tcrm.s3126

Cited by 23 publications

(3 citation statements)

References 52 publications

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“…The effectiveness of the lower ICS dose in BDP/FF may be due to the extra-fine formulation that allows homogeneous distribution of the two drugs throughout the bronchial tree [ 31 ] entailing a greater efficacy per microgram of ICS, in agreement with previous studies on asthma [ 32 - 34 ]. The extra-fine BDP/FF formulation allows the treatment of both large and small airways; the latter are particularly relevant in COPD pathophysiology [ 35 ].…”

Section: Discussionsupporting

confidence: 66%

Extrafine Beclomethasone/formoterol compared to Fluticasone/salmeterol Combination Therapy in COPD

et al. 2014

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BackgroundThe study evaluated the efficacy of beclomethasone dipropionate/formoterol fumarate (BDP/FF) extrafine combination versus fluticasone propionate/salmeterol (FP/S) combination in COPD patients.MethodsThe trial was a 12-week multicentre, randomised, double-blind, double dummy study; 419 patients with moderate/severe COPD were randomised to BDP/FF 200/12 μg or FP/S 500/50 μg twice daily. The primary objective was to demonstrate the equivalence between treatments in terms of Transition Dyspnoea Index (TDI) score and the superiority of BDP/FF in terms of change from pre-dose in the first 30 minutes in forced expiratory volume in the first second (FEV1). Secondary endpoints included lung function, symptom scores, symptom-free days and use of rescue medication, St. George’s Respiratory Questionnaire, six minute walking test and COPD exacerbations.ResultsBDP/FF was equivalent to FP/S in terms of TDI score and superior in terms of FEV1 change from pre-dose (p < 0.001). There were no significant differences between treatments in secondary outcome measures, confirming overall comparability in terms of efficacy and tolerability. Moreover, a clinically relevant improvement (>4 units) in SGRQ was detected in the BDP/FF group only.ConclusionBDP/FF extrafine combination provides COPD patients with an equivalent improvement of dyspnoea and a faster bronchodilation in comparison to FP/S.Trial registrationClinicalTrials.gov: NCT01245569

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Section: Discussionsupporting

confidence: 66%

Extrafine Beclomethasone/formoterol compared to Fluticasone/salmeterol Combination Therapy in COPD

et al. 2014

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“… 57 Nicolini and colleagues have shown that the small particle (~1.5 microns) combination therapy of ICS/LABA (BDP/Form) delivered from an HFA-solution pMDI achieved 2/3rd central airways deposition and 1/3rd peripheral airways deposition. 58 Recently, Scichilone and colleagues have replicated this distribution in the regional airways distribution of 2/3rd central and 1/3rd peripheral, for the same combination therapy of ICS/LABA (BDP/Form) delivered from a novel DPI, where the inhaler device also generates small particle (~1.5 microns) sized aerosols. 59 Hence, the development of inhalers delivering small particle aerosols now allows us to achieve deposition to treat the whole airway tree; that is, simultaneously targeting drug to the large and also the small airways.…”

Section: Introductionmentioning

confidence: 87%

“… 52 , 53 , 54 , 55 , 56 , 57 The capability to generate small particle aerosols of ICS and LABA has been utilised to improve the total lung dose of delivered drug to levels between 30 to 50%, which is a significant improvement compared to conventional devices. 56 , 57 , 58 , 59 , 60 Of greater significance is that these small aerosol particles are able to effectively deliver inhaled drug to the periphery of the lungs.…”

Section: Introductionmentioning

confidence: 99%

Small Airways Dysfunction in Asthma: Evaluation and Management to Improve Asthma Control

Usmani

2014

Allergy Asthma Immunol Res

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The small airways have been neglected for many years, but interest in the topic has been rekindled with recent advances in measurement techniques to assess this region and also the ability to deliver therapeutics to the distal airways. Current levels of disease control in asthmatic patients remain poor and there are several contributory factors including; poor treatment compliance, heterogeneity of asthma phenotypes and associated comorbidities. However, the proposition that we may not be targeting all the inflammation that is present throughout the whole respiratory tree may also be an important factor. Indeed decades ago, pathologists and physiologists clearly identified the importance of small airways dysfunction in asthmatic patients. With improved inhaler technology to deliver drug to target the whole respiratory tree and more sensitive measures to assess the distal airways, we should certainly give greater consideration to treating the small airway region when seeing our asthmatic patients in clinic. The aim of this review is to address the relevance of small airways dysfunction in the daily clinical management of patients with asthma. In particular the role of small particle aerosols in the management of patients with asthma will be explored.

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Asthma Control: The Right Inhaler for the Right Patient

Scichilone

2015

Adv Ther

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Inhaled therapy is the cornerstone of asthma management in that it optimizes the delivery of the medication to the site of action. The effectiveness of inhaled therapy is affected by the correct choice of the device and proper inhalation technique. In fact, this influences the drug delivery and distribution along the bronchial tree, including the most peripheral airways. In this context, accumulating evidence supports the contribution of small airways in asthma, and these have become an important target of treatment. In reality, the “ideal inhaler” does not exist, and not all inhalers are the same. Advances in technology has highlighted these differences, and have led to the design of new devices and the development of formulations characterized by extrafine particles that facilitate the distribution and deposition of the drug particles along the respiratory tract. In addition, efforts have been made to implement adherence to chronic treatment, which translates into clinical benefit. Taken together, the optimal control of asthma depends on the drug that is selected, the device that is employed and the removal of factors that reduce patient’s adherence to therapy.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-015-0201-9) contains supplementary material, which is available to authorized users.

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Beclomethasone/formoterol fixed combination for the management of asthma: patient considerations

Cited by 23 publications

References 52 publications

Extrafine Beclomethasone/formoterol compared to Fluticasone/salmeterol Combination Therapy in COPD

Extrafine Beclomethasone/formoterol compared to Fluticasone/salmeterol Combination Therapy in COPD

Small Airways Dysfunction in Asthma: Evaluation and Management to Improve Asthma Control

Asthma Control: The Right Inhaler for the Right Patient

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