A COMPARISON OF FLUTICASONE PROPIONATE 200-MU-G DAY WITH BECLOMETHASONE DIPROPIONATE 400-MU-G/DAY IN ADULT ASTHMA/

A total of 261 patients with symptomatic, mild to moderate asthma were randomized to treatment in this 4-week, double-blind, parallel-group comparison of fluticasone propionate 200 mug/d with beclomethasone dip ropionate 400 mug/d. Improvements from both treatments were seen in di ary card data. Morning peak expiratory flow rate (PEFR) improved from 375 to 390 and 371 to 382 l/min with fluticasone propionate and beclom ethasone dipropionate, respectively. Symptom scores, percentage of sym ptom-free days and nights, and use of rescue beta2-agonist medication also improved, as did clinical lung function. With the exception of pe rcentage of rescue-free days, which was greater for beclomethasone dip ropionate, none of the differences between the groups were statistical ly significant. There was a significant difference between treatments in the number of rescue-free days over days 1-28; however, there was n o difference between treatments in the number of rescue-free days over days 1-14, nor was there any difference in the number of inhalations of rescue medication used throughout the study. Very few adverse effec ts were reported. Although all mean plasma cortisol values were within the normal range, they were significantly different between treatment s, rising from 402 to 429 nmol/l with fluticasone propionate, and fall ing from 435 to 394 nmol/l with beclomethasone dipropionate (P = 0.006 ). Mean stimulated cortisol levels 30 min after tetracosactin injectio n were also significantly greater with fluticasone propionate (P = 0.0 24). In conclusion, fluticasone propionate 200 mug/d is as effective a s beclomethasone dipropionate 400 mug/d with less effect on plasma cor tisol levels.