Ab. Tonnel et I. Evanocelli, INHALED BECLOMETHASONE DIPROPIONATE IN TH E TREATMENT OF MILD PERSISTENT ASTHMA IN A PRIMARY CASE SETTING, La Semaine des hopitaux de Paris, 74(3-4), 1998, pp. 109-117
Inhaled steroids are currently the recommended first-line treatment fo
r mild persistent asthma. An open-label pragmatic study was conducted
by general practitioners to evaluate the effect of three months of tre
atment with low-dose (500 mu g/d) inhaled beclomethasone dipropionate
(BDP) in adults. Of the 173 included patients, 121 entered the treatme
nt period at the end of the run-in period. The number of evaluable pat
ients was 110. Efficacy was evaluated based on patient diary data, a v
isual analog scale (VAS) for respiratory discomfort completed by the p
atients at each visit, and lung function parameters. Patients were req
uired to have used only short-acting beta2-adrenoceptor agonists as tr
eatment for their asthma during the last month. Also, during the last
seven days of the run-in period, they had to have used salbutamol on a
t least three occasions, or to have had at least three peak expiratory
flow rate (PEFR) values less than or equal to 80% of predicted, or to
have had during at least three days a diurnal change in PEFR greater
than or equal to 20%. Morning PEFR (primary criterion) increased by 40
L/min (p=0.0001). Similarly, evening PEFR rose by 36 L/min (p=0.0001)
, and FEV1 increased by 0.34L (p=0.0001). Proportions of patients with
dyspnea, cough, and wheezing fell from 63% to 24%, from 36% to 11%, a
nd from 33% to 7%, respectively. VAS scores showed a 52% improvement i
n respiratory discomfort. The median use of salbutamol fell from 1.33
to 0.57 times per day. All differences between the run-in period and t
he end of the treatment period were statistically significant (p=0.000
1 for all criteria). The incidence and type of adverse events were con
sistent with previously published data on BDP. Long-term treatment wit
h 500 mu g/d inhaled BDP was associated with improvements in clinical
features, lung function parameters, and well-being in adults with symp
tomatic mild persistent asthma.