One-year evaluation of the preventative effect of hydrofluoroalkane-beclomethasone dipropionate on eosinophilic inflammation of asthmatic peripheral airways.

Abstract

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 microg/l (p = 0.037) in the FP-DK group, and 3,850.0 +/- 5,486.2 versus 492.0 +/- 1,150.7 microg/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.

• Authors: Hiroyuki Ohbayashi
• Journal: Respiration; international review of thoracic diseases (Respiration) Vol. 74 Issue 2 Pg. 146-53 ( 2007) ISSN: 0025-7931 [Print] Switzerland
• PMID: 16804291 (Publication Type: Journal Article)

Chemical References

• Aerosol Propellants
• Glucocorticoids
• Hydrocarbons, Fluorinated
• Beclomethasone
• apaflurane

Topics

• Administration, Inhalation
• Aerosol Propellants (administration & dosage)
• Aged
• Asthma (complications, drug therapy, physiopathology)
• Beclomethasone (administration & dosage)
• Bronchitis (complications, pathology, prevention & control)
• Eosinophilia (pathology, prevention & control)
• Eosinophils (pathology)
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage)
• Humans
• Hydrocarbons, Fluorinated (administration & dosage)
• Leukocyte Count
• Male
• Middle Aged
• Sputum (cytology)
• Time Factors
• Treatment Outcome
• Vital Capacity (physiology)