Rm. Du Bois et al., Randomized trial of inhaled fluticasone propionate in chronic stable pulmonary sarcoidosis: a pilot study, EUR RESP J, 13(6), 1999, pp. 1345-1350
Pulmonary sarcoidosis is a disease in which the pathological processes are
distributed along lymphatic pathways, particularly those around the broncho
vascular bundles, Delivery of disease-modulating drugs by the inhaled route
is therefore an attractive option, The aim of this study was to determine
the efficacy of inhaled fluticasone propionate 2 mg.day(-1) in adults,vith
stable pulmonary sarcoidosis.
Forty-four adult patients (22 from each centre) were enrolled from outpatie
nt clinics in two London teaching hospitals in a two centre, double-blind,
randomized, placebo-controlled trial.
Primary end points were home recordings of peak expiratory flow rate (PEFR)
, forced expiratory volume in one second (FEV1), and forced vital capacity
(FVC), Secondary end points were symptom scores, use of rescue bronchodilat
or medication, and clinic values for PEFR, FEV1, FVC, forced mid-expiratory
flow (FEF25-75%), diffusion capacity of the lung for carbon monoxide (DL,C
O), and total lung capacity (TLC),
Symptom scores of cough, breathlessness and wheeze were lower in the active
treatment group, but this did not reach statistical significance, and a ge
neral health perception assessment (Short Form (SF)36) showed a difference
between active and placebo treatment. No significant differences were found
between the two groups in any physiological outcome measure, No new advers
e reactions were detected,
The results of this pilot study do not show an objective benefit of inhaled
fluticasone propionate in pulmonary sarcoidosis where the disease is stabl
e and is controlled,without the use of inhaled corticosteroids.