COMPARISON OF INHALED BECLOMETHASONE DIPROPIONATE 1000 MU-G TWICE-DAILY AND ORAL PREDNISONE 10 MG ONCE-DAILY IN ASTHMATIC-PATIENTS

Background - Glucocorticosteroids are widely used as drugs of first ch oice in the treatment of moderate to severe asthma. The effects of inh aled steroids in high doses have been compared with oral prednisone in asthmatic patients in a double blind crossover study. Methods - The t rial consisted of a two week run in period followed by two four week t reatment periods separated by a four week washout. During the treatmen t period patients took either 1000 mu g beclomethasone dipropionate tw ice daily and placebo tablets once daily, or 10 mg prednisone daily in one morning dose and placebo inhaler twice daily. The effects of trea tment on the provocative dose of histamine producing a 20% fall in FEV (1) (PC20 histamine), peak flow measurements at home, and spirometric measurements in the clinic, as well as on the basal and stimulated pla sma cortisol levels were measured. Results - Seventeen patients with a sthma completed the study. After four weeks of treatment beclomethason e dipropionate showed a significantly better effect on morning peak ex piratory how rate than prednisone. There was a trend to a greater impr ovement in the PC20 histamine in patients receiving beclomethasone dip ropionate than in those receiving prednisone. There were no significan t differences in spirometric values, symptom scores, or basal and stim ulated cortisol levels between the treatments. The within treatment an alysis showed a significant effect of prednisone on stimulated cortiso l levels but not of beclomethasone dipropionate. Conclusions - Beclome thasone dipropionate 1000 mu g twice daily has a slightly greater ther apeutic effect in this population of asthmatic patients than 10 mg of prednisone once a day with less effect on adrenocortical function.