Fluticasone versus beclomethasone or budesonide for chronic asthma in adults and children

Adams, Nick; Lasserson, Toby J; Cates, Christopher J; Jones, Paul

doi:10.1002/14651858.cd002310.pub4

Cited by 58 publications

(22 citation statements)

References 79 publications

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“…It's already been tested and used in combination with corticosteroids, such as budesonide, to treat or prevent asthma attack and/or respiratory tract inflammation. Fluticasone, another potent glucocorticoid, has been shown to have superior or similar efficacy in improving pulmonary functions in asthma patients3233. The predicted Formoterol/Fluticasone combination can be adopted as a new and alternative option in the management of asthma or COPD along the same combination strategy as Formoterol/Budesonide.…”

Section: Resultsmentioning

confidence: 99%

Systematic prediction of drug combinations based on clinical side-effects

Huang

Zhang

et al. 2014

Sci Rep

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Drug co-prescription (or drug combination) is a therapeutic strategy widely used as it may improve efficacy and reduce side-effect (SE). Since it is impractical to screen all possible drug combinations for every indication, computational methods have been developed to predict new combinations. In this study, we describe a novel approach that utilizes clinical SEs from post-marketing surveillance and the drug label to predict 1,508 novel drug-drug combinations. It outperforms other prediction methods, achieving an AUC of 0.92 compared to an AUC of 0.69 in a previous method, on a much larger drug combination set (245 drug combinations in our dataset compared to 75 in previous work.). We further found from the feature selection that three FDA black-box warned serious SEs, namely pneumonia, haemorrhage rectum, and retinal bleeding, contributed mostly to the predictions and a model only using these three SEs can achieve an average area under curve (AUC) at 0.80 and accuracy at 0.91, potentially with its simplicity being recognized as a practical rule-of-three in drug co-prescription or making fixed-dose drug combination. We also demonstrate this performance is less likely to be influenced by confounding factors such as biased disease indications or chemical structures.

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Section: Resultsmentioning

confidence: 99%

Systematic prediction of drug combinations based on clinical side-effects

Huang

Zhang

et al. 2014

Sci Rep

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“…The results are concordant with the findings of the other studies that FP is more efficacious than BDP but is in contrast to another study that did not show the higher efficacy of FP. [1925]…”

Section: Discussionmentioning

confidence: 99%

The effect of inhaled corticosteroids on hypothalamic-pituitary-adrenal axis

et al. 2012

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Objectives:The aim of this study was to compare systemic effects of high-dose fluticasone propionate (FP) and beclomethasone dipropionate (BDP) via pressurized metered dose inhaler on adrenal and pulmonary function tests.Materials and Methods:A total of 66 patients with newly diagnosed moderate persistent asthma without previous use of asthma medications participated in this single blind, randomized, parallel design study. FP or BDP increased to 1 500 μg/d in 62 patients who had not received oral or IV corticosteroids in the previous six months. Possible effects of BDP and FP on adrenal function were evaluated by free cortisol level at baseline and after Synacthen test (250 μg). Fasting plasma glucose and pulmonary function tests were also assessed. Similar tests were repeated 3 weeks after increasing dose of inhaled corticosteroids to 1 500 μg/d.Results:No statistically significant suppression was found in geometric means of cortisol level post treatment in both groups. After treatment in FP group, mean forced expiratory volume in one second (FEV1) and mean forced vital capacity (FVC) values improved by 0.17 l (5.66% ± 13.91, P=0.031) and 0.18 l (5.09% ± 10.29, P=0.010), respectively. Although FEV1 and FVC improved in BDP group but was not statistically significant. Oral candidiasis and hoarseness were observed in 6.5% patients receiving BDP, but hoarseness was found in 3.2% patients in FP group (P=0.288).Conclusions:The results indicate that safety profiles of high doses of BDP and FP with respect to adrenal function are similar, but FP is more efficacious than that of BDP in improving pulmonary function test.

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“…In order to calculate the costs attributed to daily and intermittent therapy with ICS, we used the costs of beclomethasone dipropionate (BDP), because it was the ICS used in two of the four included studies, 8,13 and two Cochrane systematic reviews conclude that in general all ICS at equipotent doses provide a similar level of asthma control. 23,24 In addition, BDP is the only ICS included in the Compulsory Health Insurance Plan of Colombia. Calculation of the daily therapy with ICS was based on the estimated average daily dose appropriate for treating pediatric patients with mild persistent asthma, according to current national and international asthma guidelines, 25,26 and the relative use of available concentrations for each medication according to current market research.…”

Section: Data Inputs: Resource Utilization and Costsmentioning

confidence: 99%

Cost‐utility analysis of daily versus intermittent inhaled corticosteroids in mild‐persistent asthma

Rodríguez‐Martínez

Niño

Castro-Rodriguez

2014

Pediatric Pulmonology

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Summary Introduction Despite the many benefits that have been demonstrated by the continuous administration of inhaled corticosteroids (ICS) in persistent asthma, a new strategy for mild-asthma is emerging, consisting of using intermittent or as-needed ICS treatment in conjunction with short-acting beta2 agonists in response to symptoms. However, no previous studies have reported an economic evaluation comparing these two therapeutic strategies. Methods A Markov-type model was developed in order to estimate costs and health outcomes of a simulated cohort of pediatric patients with persistent asthma treated over a 12-month period. Effectiveness parameters were obtained from a systematic review of the literature. Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable “quality-adjusted life-years” (QALYs). Results For the base-case analysis, the model showed that compared to intermittent ICS, daily therapy with ICS had lower costs (US $437.02 vs. 585.03 and US$704.62 vs. 749.81 average cost per patient over 12 months for school children and preschoolers, respectively), and the greatest gain in QALYs (0.9629 vs. 0.9392 QALYs and 0.9238 vs. 0.9130 QALYS for school children and preschoolers, respectively), resulting in daily therapy being considered dominant. Conclusions The present analysis shows that compared to intermittent therapy, daily therapy with ICS for treating pediatric patients with recurrent wheezing and mild persistent asthma is a dominant strategy (more cost effective), because it showed a greater gain in QALYs with lower total treatment costs. Pediatr Pulmonol.

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Fluticasone versus beclomethasone or budesonide for chronic asthma in adults and children

Abstract: Analysis 1.4. Comparison 1 FP versus BDP or BUD, parallel group studies: dose ratio 1:2, Outcome 4 Change in FEV1 (% predicted

Cited by 58 publications

References 79 publications

Systematic prediction of drug combinations based on clinical side-effects

Systematic prediction of drug combinations based on clinical side-effects

The effect of inhaled corticosteroids on hypothalamic-pituitary-adrenal axis

Cost‐utility analysis of daily versus intermittent inhaled corticosteroids in mild‐persistent asthma

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