INHALED BECLOMETHASONE DIPROPIONATE IN TH E TREATMENT OF MILD PERSISTENT ASTHMA IN A PRIMARY CASE SETTING

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.