Efficacy and safety overview of a new inhaled corticosteroid, QVAR (hydrofluoroalkane-beclomethasone extrafine inhalation aerosol), in asthma

Chlorofluorocarbon (CFC)-containing inhalers are gradually being phased out and replaced with hydrofluoroalkane (HFA)-based alternatives, The reformul ation provided the opportunity to improve the inhalation technology and phy sical characteristics of corticosteroid formulations. QVAR contains HFA-bec lomethasone dipropionate (HFA-BDP) with the steroid in solution rather than suspension, which, in combination with improved inhaler technology, produc es an extrafine aerosol with a mass median aerodynamic diameter of 1.1 mum (smaller than the 3.5-4.0 mum found with CFC-BDP). It mas predicted and dem onstrated that the smaller particle size of QVAR would be deposited in the lung to a greater extent than that found with CFC-BDP, particularly in the small airway, a major site of inflammation. Increased lung deposition of QV AR permits a reduction in dosage relative to CFC-BDP, Clinical evidence con firms that adult and elderly patients required approximately. half the dose of QVAR to achieve the same degree of asthma control as with CFC-BDP. In l ongterm assessments, patients taking CFC-BDP could he snitched to QVAR at h alf the daily dose without exacerbation of their asthma symptoms, QVAR was associated with a low overall incidence of side effects and, at the maximum recommended dose of 640 mug/d, caused no more adrenal suppression than 672 mug/d CFC-BDP.