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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/3191

Title: Safety and efficacy of fluticasone and beclomethasone in moderate to severe asthma
Authors: Pauwels, RA
Yernault, JC
Demedts, MG
GEUSENS, Piet
Issue Date: 1998
Publisher: AMER LUNG ASSOC
Citation: AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 157(3). p. 827-832
Abstract: There are still some concerns about the safety of high doses of inhaled glucocorticosteroids (ICS). We compared the safety and efficacy of fluticasone propionate (FP) and beclomethasone dipropionate (BDP) in 306 patients with moderate to severe asthma in a double-blind, multicenter, cross-over study of 12 mo duration. During the 1-mo run-in period, bronchodilators were replaced by salmeterol 50 mu g twice daily, increasing morning peak expiratory flow rate (PEFR) by 28 L/min (p < 0.001) and FEV1 by 6.2% predicted (p < 0.001). At randomization the current ICS was replaced by 500 mu g BDP or 250 mu g FP in accordance with previously taken 500 mu g BDP or 400 mu g budesonide (BUD). No significant differences between the two treatments regarding morning plasma cortisol, urinary excretion of calcium and hydroxyproline, FEV1, and PEFR were observed at any time point during the study. Osteocalcin and bone mineral density (BMD) were improved over baseline in the FP group, resulting in higher serum osteocalcin levels (mean difference 0.28 ng/ml; p < 0.001) and higher BMD in the spine (1.0%; p = 0.05), femoral neck (1.6; p < 0.01), and Ward's triangle (3.6%; p = 0.01) as compared with BDP. We conclude that chronic treatment with FP, at half the dose of BDP, results in a similar antiasthma effect but a more favorable safety profile with respect to bone metabolism and mineral density.
Notes: State Univ Ghent Hosp, Dept Resp Dis, B-9000 Ghent, Belgium. Univ Hosp, Brussels, Belgium. Univ Hosp, Louvain, Belgium. LUC Diepenbeek, Dr Willems Inst, Diepenbeek, Belgium.Pauwels, RA, State Univ Ghent Hosp, Dept Resp Dis, De Pintelaan 185, B-9000 Ghent, Belgium.
URI: http://hdl.handle.net/1942/3191
ISI #: 000072443200024
ISSN: 1073-449X
Type: Journal Contribution
Validation: ecoom, 1999
Appears in Collections: Research publications

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