Hydrofluoroalkane-Beclomethasone Dipropionate Effectively Improves Airway Eosinophilic Inflammation Including the Distal Airways of Patients with Mild to Moderate Persistent Asthma as Compared with Fluticasone Propionate in a Randomized Open Double-Cross Study
Background: To evaluate whether hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) controls eosinophilic inflammation, including that in the distal airways, more effectively than fluticasone propionate (FP) Diskus®. Methods: Fifty patients with well-controlled mild to moderate persistent asthma...
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| Format: | Article |
| Language: | English |
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Elsevier
2008-01-01
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| Series: | Allergology International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1323893015307784 |
| _version_ | 1811278929874386944 |
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| author | Hiroyuki Ohbayashi Mitsuru Adachi |
| author_facet | Hiroyuki Ohbayashi Mitsuru Adachi |
| author_sort | Hiroyuki Ohbayashi |
| collection | DOAJ |
| description | Background: To evaluate whether hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) controls eosinophilic inflammation, including that in the distal airways, more effectively than fluticasone propionate (FP) Diskus®.
Methods: Fifty patients with well-controlled mild to moderate persistent asthma using FP for more than 6 months were randomly assigned to FP and HFA-BDP groups, and the treatment regimens of the two groups were switched twice between FP and HFA-BDP in a double cross-over manner at 3-month intervals after 2-week washout periods. Evidence of eosinophilic inflammation in blood and induced sputum samples was assessed, together with pulmonary function testing and an Asthma-related Quality of Life Questionnaire (AQLQ) survey after each treatment period.
Results: The peripheral blood differential eosinophil count and sputum levels of eosinophil cationic protein (ECP) showed reciprocal changes during the study periods in both groups. The blood differential eosinophil count was significantly lower during the HFA-BDP than during the FP treatment period in both the FP (p = 0.004) and the HFA-BDP (p = 0.020) group. The late-phase induced sputum ECP level was significantly decreased during the HFA-BDP treatment period in both the FP (p = 0.016) and the HFA-BDP group (p = 0.023). The significant elevation of surfactant protein D values in the late-phase sputum observed in both groups indicated that late-phase sputum was obtained mainly from proximal peripheral airways. Both symptom and activity limitation domains of the AQLQ in the HFA-BDP group significantly increased after switching from FP to HFA-BDP. There were no significant changes in pulmonary function indices in either group at any time during the study.
Conclusions: HFA-BDP improved residual eosinophilic inflammation in asthmatic airways, including distal airways, more effectively than FP. |
| first_indexed | 2024-04-13T00:45:37Z |
| format | Article |
| id | doaj.art-9a24e756fb9240988cd1b77fb683718f |
| institution | Directory Open Access Journal |
| issn | 1323-8930 |
| language | English |
| last_indexed | 2024-04-13T00:45:37Z |
| publishDate | 2008-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Allergology International |
| spelling | doaj.art-9a24e756fb9240988cd1b77fb683718f2022-12-22T03:10:01ZengElsevierAllergology International1323-89302008-01-0157323123910.2332/allergolint.O-07-522Hydrofluoroalkane-Beclomethasone Dipropionate Effectively Improves Airway Eosinophilic Inflammation Including the Distal Airways of Patients with Mild to Moderate Persistent Asthma as Compared with Fluticasone Propionate in a Randomized Open Double-Cross StudyHiroyuki Ohbayashi0Mitsuru Adachi1Department of Allergy and Respiratory Medicine, Tohno-Kousei Hospital, Gifu, JapanDepartment of 1st Internal Medicine, Showa University, Tokyo, Japan.Background: To evaluate whether hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) controls eosinophilic inflammation, including that in the distal airways, more effectively than fluticasone propionate (FP) Diskus®. Methods: Fifty patients with well-controlled mild to moderate persistent asthma using FP for more than 6 months were randomly assigned to FP and HFA-BDP groups, and the treatment regimens of the two groups were switched twice between FP and HFA-BDP in a double cross-over manner at 3-month intervals after 2-week washout periods. Evidence of eosinophilic inflammation in blood and induced sputum samples was assessed, together with pulmonary function testing and an Asthma-related Quality of Life Questionnaire (AQLQ) survey after each treatment period. Results: The peripheral blood differential eosinophil count and sputum levels of eosinophil cationic protein (ECP) showed reciprocal changes during the study periods in both groups. The blood differential eosinophil count was significantly lower during the HFA-BDP than during the FP treatment period in both the FP (p = 0.004) and the HFA-BDP (p = 0.020) group. The late-phase induced sputum ECP level was significantly decreased during the HFA-BDP treatment period in both the FP (p = 0.016) and the HFA-BDP group (p = 0.023). The significant elevation of surfactant protein D values in the late-phase sputum observed in both groups indicated that late-phase sputum was obtained mainly from proximal peripheral airways. Both symptom and activity limitation domains of the AQLQ in the HFA-BDP group significantly increased after switching from FP to HFA-BDP. There were no significant changes in pulmonary function indices in either group at any time during the study. Conclusions: HFA-BDP improved residual eosinophilic inflammation in asthmatic airways, including distal airways, more effectively than FP.http://www.sciencedirect.com/science/article/pii/S1323893015307784asthmaAsthma-related Quality of Life Questionnaire (AQLQ)eosinophil cationic protein (ECP)fluticasone propionate (FP) Diskus®hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) |
| spellingShingle | Hiroyuki Ohbayashi Mitsuru Adachi Hydrofluoroalkane-Beclomethasone Dipropionate Effectively Improves Airway Eosinophilic Inflammation Including the Distal Airways of Patients with Mild to Moderate Persistent Asthma as Compared with Fluticasone Propionate in a Randomized Open Double-Cross Study Allergology International asthma Asthma-related Quality of Life Questionnaire (AQLQ) eosinophil cationic protein (ECP) fluticasone propionate (FP) Diskus® hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) |
| title | Hydrofluoroalkane-Beclomethasone Dipropionate Effectively Improves Airway Eosinophilic Inflammation Including the Distal Airways of Patients with Mild to Moderate Persistent Asthma as Compared with Fluticasone Propionate in a Randomized Open Double-Cross Study |
| title_full | Hydrofluoroalkane-Beclomethasone Dipropionate Effectively Improves Airway Eosinophilic Inflammation Including the Distal Airways of Patients with Mild to Moderate Persistent Asthma as Compared with Fluticasone Propionate in a Randomized Open Double-Cross Study |
| title_fullStr | Hydrofluoroalkane-Beclomethasone Dipropionate Effectively Improves Airway Eosinophilic Inflammation Including the Distal Airways of Patients with Mild to Moderate Persistent Asthma as Compared with Fluticasone Propionate in a Randomized Open Double-Cross Study |
| title_full_unstemmed | Hydrofluoroalkane-Beclomethasone Dipropionate Effectively Improves Airway Eosinophilic Inflammation Including the Distal Airways of Patients with Mild to Moderate Persistent Asthma as Compared with Fluticasone Propionate in a Randomized Open Double-Cross Study |
| title_short | Hydrofluoroalkane-Beclomethasone Dipropionate Effectively Improves Airway Eosinophilic Inflammation Including the Distal Airways of Patients with Mild to Moderate Persistent Asthma as Compared with Fluticasone Propionate in a Randomized Open Double-Cross Study |
| title_sort | hydrofluoroalkane beclomethasone dipropionate effectively improves airway eosinophilic inflammation including the distal airways of patients with mild to moderate persistent asthma as compared with fluticasone propionate in a randomized open double cross study |
| topic | asthma Asthma-related Quality of Life Questionnaire (AQLQ) eosinophil cationic protein (ECP) fluticasone propionate (FP) Diskus® hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) |
| url | http://www.sciencedirect.com/science/article/pii/S1323893015307784 |
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