The Journal of Allergy and Clinical Immunology
Volume 94, Issue 4 , Pages 676-683, October 1994

Fluticasone propionate aerosol for the treatment of adults with mild to moderate asthma

North Dartmouth, Mass., U.S.A.

Received 14 April 1993; received in revised form 7 January 1994; accepted 30 March 1994.

Article Outline

Abstract 

Background: Recent emphasis on the control of airway inflammation in asthma highlights the need for safe and effective antiinflammatory agents. Fluticasone propionate is one of the most potent antiinflammatory corticosteroids developed to date.

Objective: This study assessed the safety and efficacy of fluticasone propionate aerosol in the treatment of mild to moderate asthma.

Methods: Fluticasone propionate aerosol (25, 100, or 500 μg twice daily) or placebo was given for as long as 8 weeks to adults with mild to moderate asthma in a randomized, double-blind, parallel-group study. Patients were removed from the study if they showed predefined signs of worsening asthma.

Results: Sixty-three percent of placebo-treated patients and 23%, 13%, and 4% of patients treated with fluticasone propionate 25, 100, and 500 μg twice daily, respectively, were removed from the study. Mean forced expiratory volume in 1 second, forced vital capacity, and forced expiratory flow at midexpiratory phase at weekly visits throughout the study demonstrated that fluticasone propionate was more efficacious than placebo in maintaining asthma control. Measurements of peak expiratory flow and symptom scores significantly improved and nighttime awakenings and albuterol use to treat symptoms significantly declined in fluticasone propionate-treated groups relative to the placebo-treated group. Differences among fluticasone propionate groups for these variables were not statistically significant. Incidence and severity of adverse events were similar across groups. Fluticasone propionate did not affect morning or stimulated plasma cortisol concentrations, although slight, transient reductions in urinary free cortisol and urinary 17-hydroxy steroids occurred in the group receiving 500 μg fluticasone propionate twice daily.

Conclusion: These data indicate that fluticasone propionate provides safe and effective treatment for mild to moderate asthma.

Keywords:  Asthma, fluticasone propionate, inhaled corticosteroid

Abbreviations:  FEF25%–75%, Forced expiratory flow at midexpiratory phase, FEV1, Forced expiratory volume in 1 second, FVC, Forced vital capacity, PFT, Pulmonary function tests

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Chestnutt MS, Lazarus SC. Asthma therapy in the nineties: focus on inflammation. Hosp Formulary. 1992;27:466–482
  2. Sheffer AL. Guidelines for the diagnosis and management of asthma: National Heart, Lung, and Blood Institute, national asthma education program expert panel report. J Allergy Clin Immunol. 1991;88:425–534 (Suppl)
  3. Geddes DM. Inhaled corticosteroids: benefits and risks. Thorax. 1992;47:404–407
  4. Phillipps GH. Structure-activity relationships of topically active steroids: the selection of fluticasone propionate. Resp Med. 1990;84(Suppl A):19–23
  5. Harding SM. The human pharmacology of fluticasone propionate. Resp Med. 1990;84(Suppl A):25–29
  6. Barnes NC, Marone G, Di Maria GU, Visser S, Utama I, Payne SL. A comparison of fluticasone propionate, 1 mg daily, with beclomethasone dipropionate, 2 mg daily, in the treatment of severe asthma. Eur Resp J. 1993;6:877–884
  7. Fabbri L, Burge PS, Croonenborgh L, et al.  Comparison of fluticasone propionate with beclomethasone dipropionate in moderate to severe asthma treated for one year. Thorax. 1993;48:817–823
  8. Gustafsson P, Tsanakas J, Gold M, Primhak R, Radford M, Gillies E. Comparison of the efficacy and safety of inhaled fluticasone propionate 200 mcg/day with inhaled beclomethasone dipropionate 400 mcg/day in mild and moderate asthma. Arch Dis Child. 1993;69:206–211
  9. Committee on Diagnostic Standards for Nontuberculosis Respiratory Diseases . Definitions and classification of chronic bronchitis, asthma and pulmonary emphysema. Am Rev Respir Dis. 1962;85:762–768
  10. Gaddie J, Reid IW, Skinner C, et al.  Aerosol beclomethasone dipropionate: a dose-response study in chronic bronchial asthma. Lancet. 1973;2:280–281
  11. Hummel S, Lehtonen L. Comparison of oral-steroid sparing by high-dose and low-dose inhaled steroid in maintenance treatment of severe asthma. Lancet. 1992;340:1483–1487
  12. Costello JF, Clarke TJH. Response of patients receiving high dose beclomethasone dipropionate. Thorax. 1974;29:571–573
  13. Toogood HJ, Lefcoe NM, Haines DSM, et al.  A graded dose assessment of the efficacy of beclomethasone dipropionate aerosol for severe chronic asthma. J Allergy Clin Immunol. 1977;59:298–308
  14. Tarlo SM, Broder I, Davies GM, Leznoff A, Mintz S, Corey PN. Six-month double-blind, controlled trial of high dose, concentrated beclomethasone dipropionate in the treatment of severe chronic asthma. Chest. 1988;93:998–1002
  15. Williams AJ, Baghat MS, Stableforth DE, Cayton RM, Shenoi PM, Skinner C. Dysphonia caused by inhaled steroids: recognition of a characteristic laryngeal abnormality. Thorax. 1983;38:813–821

 This study was funded in part by Glaxo Research Institute.

PII: 0091-6749(94)90174-0

The Journal of Allergy and Clinical Immunology
Volume 94, Issue 4 , Pages 676-683, October 1994