Abstract
The effect of inhaled beclomethasone dipropionate (dose, 400 μg daily) was investigated in 31 prednisone-dependent asthmatics. In a double-blind noncrossover study of 25 patients dependent on a daily prednisone dose of 17.5 mg or less, the dose of ingested prednisone was significantly diminished through the use of beclomethasone as compared with placebo (P < 0.001). In a subsequent single-blind study of the 12 patients who had received placebo, a similar decrease in prednisone dose was possible when these patients received beclomethasone. In all 25 patients the effect of beclomethasone was maintained for 2 years; 9 came to require less beclomethasone and 1 required more. In an additional single-blind study of six patients with severe asthma, dependent on prednisone in a dose of 20 to 25 mg/d, the response to beclomethasone was more variable and less significant (P < 0.01). However, at 2 years there was no significant benefit (P > 0.05) and there were two treatment failures.
In patients in whom reduction of dose or discontinuation of prednisone was possible plasma cortisol values before and after corticotropin administration increased significantly (P < 0.001). Prednisone reduction was associated with the appearance of mild musculoskeletal steroid-withdrawal symptoms of short duration in 15 patients, and recurrence of symptoms of rhinitis in 15 patients. Side effects of beclomethasone included episodes of hoarseness in 6 and easily treated oropharyngeal Candida albicans infection in 14.
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Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Andersson E. An investigation of the bronchial mucous membrane after long-term treatment with beclomethasone dipropionate. Postgrad Med J. 1975;51 (Suppl 4):32–35. [PubMed] [Google Scholar]
- Clark T. J., Costello J. F., Soutar C. A. The effects of beclomethasone dipropionate aerosol given in high doses to patients with asthma. Postgrad Med J. 1975;51 (Suppl 4):72–75. [PubMed] [Google Scholar]
- Daly J. R., Myles A. B., Bacon P. A., Beardwell C. G., Savage O. Pituitary adrenal function during corticosteroid withdrawal in rheumatoid arthritis. Ann Rheum Dis. 1967 Jan;26(1):18–25. doi: 10.1136/ard.26.1.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dluhy R. G., Himathongkam T., Greenfield M. Rapid ACTH test with plasma aldosterone levels. Improved diagnostic discrimination. Ann Intern Med. 1974 Jun;80(6):693–696. doi: 10.7326/0003-4819-80-6-693. [DOI] [PubMed] [Google Scholar]
- Falliers C. J., Chai H., Molk L., Bane H., Cardoso R. R. Pulmonary and adrenal effects of alternate-day corticosteroid therapy. J Allergy Clin Immunol. 1972 Mar;49(3):156–166. doi: 10.1016/0091-6749(72)90109-1. [DOI] [PubMed] [Google Scholar]
- Gibson G. J., Maberly D. J., Lal S., Ali M. M., Butler A. G. Double-blind cross-over trial comparing intranasal beclomethasone dipropionate and placebo in perennial rhinitis. Br Med J. 1974 Nov 30;4(5943):503–504. doi: 10.1136/bmj.4.5943.503. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hargreave F. E., McCarthy D. S., Pepys J. Steroid "pseudorheumatism" in asthma. Br Med J. 1969 Feb 15;1(5641):443–444. doi: 10.1136/bmj.1.5641.443-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hodson M. E., Batten J. C., Clarke S. W., Gregg I. Beclomethasone dipropionate aerosol in asthma. Transfer of steroid-dependent asthmatic patients from oral prednisone to beclomethasone dipropionate aerosol. Am Rev Respir Dis. 1974 Oct;110(4):403–408. doi: 10.1164/arrd.1974.110.4.403. [DOI] [PubMed] [Google Scholar]
- Jack D. Symposium on allergic lung disease. V. Selective drug treatments for bronchial asthma. Can Med Assoc J. 1974 Feb 16;110(4):436–passim. [PMC free article] [PubMed] [Google Scholar]
- Keane P. M., Stuart J., Mendez J., Barbadoro S., Walker W. H. Rapid, specific assay for plasma cortisol by competitive protein binding. Clin Chem. 1975 Sep;21(10):1474–1478. [PubMed] [Google Scholar]
- Martin L. E., Harrison C., Tanner R. J. Metabolism of beclomethasone dipropionate by animals and man. Postgrad Med J. 1975;51 (Suppl 4):11–20. [PubMed] [Google Scholar]
- McAllen M. K., Kochanowski S. J., Shaw K. M. Steroid aerosols in asthma: an assessment of betamethasone valerate and a 12-month study of patients on maintenance treatment. Br Med J. 1974 Feb 2;1(5900):171–175. doi: 10.1136/bmj.1.5900.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams M. H., Jr, Kane C., Shim C. S. Treatment of asthma with triamcinolone acetonide delivered by aerosol. Am Rev Respir Dis. 1974 May;109(5):538–543. doi: 10.1164/arrd.1974.109.5.538. [DOI] [PubMed] [Google Scholar]