מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Flunisolide delivered by a hydrofluoroalkane-(HFA) driven inhaler is as effective in asthma control as higher doses provided by a chlorofluorocarbon-(CFC) powered device, researchers report in the November issue of the Annals of Allergy, Asthma and Immunology.
Dr. Jonathan Corren of the Allergy Research Foundation Inc, Los Angeles, and colleagues note that HFA flunisolide formulations, designed to replace those in environmentally-harmful CFC devices, have a smaller median droplet diameter which achieves greater airway deposition and "may allow use of a lower dose of inhaled corticosteroid."
To investigate, the researchers enrolled 669 mild to moderate asthmatics in a randomized, placebo-controlled, double-blind study. The patients received CFC 500 mcg twice daily in a 2-week active run-in phase. This was followed by 12 weeks of twice daily flunisolide 85, 170 or 340 mcg via HFA inhaler or 250, 500 or 1000 mcg via CFC inhaler.
At follow-up, compared with placebo, those in the 170 and 340 mcg HFA groups showed a significant improvement in lung function (FEV1). In fact, both HFA and CFC formulations "were clearly superior in efficacy to placebo" and were well tolerated.
In addition, "the dose-response relationship for the increase in FEV1 was linear and of similar magnitude for both HFA and CFC flunisolide, although the HFA doses were one third of the CFC doses."
Furthermore, the investigators conclude, "the HFA formulation was numerically superior to the CFC formulation in all secondary endpoints, including peak expiratory flow rate, symptom scores, and albuterol use."
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