Table 4.
Clinical outcomes as described by some studies on extrafine particle sizes of ICS
| Authors | Subjects | Treatment | Period | Assessment methods | Outcomes |
|---|---|---|---|---|---|
| Juniper et al85 | 473 stable asthma | CFC-BDP 400–1600 μg, then switch to half dose HFA-BDP (n = 354) | 12 months | AQLQ Pulmonary function tests |
Greater improvements in AQLQ scores while treated with HFA-BDP. No difference in lung function parameters, symptoms, or β2-agonist use. |
| Worth et al86 | 209 moderate-to-severe asthma | HFA-BDP 800 μg (n = 111) versus BUD 1600 μg (n = 98) | 8 weeks | Symptoms Pulmonary function tests |
Greater improvements in the percentage of days with no experience of shortness of breath, chest tightness or wheeze, nights without sleep disturbance, and daily asthma symptoms while treated with HFA-BDP. No difference in FEV1, PEF, or β2-agonist use. |
| Tatsis et al87 | 40 moderate asthma or COPD | BUD 400 μg bid or FP 250 μg bid, then switch to HFA-BDP 200 μg (n = 20) | 8 weeks | Symptoms Pulmonary function tests |
Greater improvements in respiratory symptoms, spirometric values, and β2-agonist use while treated with HFA-BDP. |
| Boulet et al88 | 141 moderate-to-severe asthma | HFA-BDP 800 μg (n = 70) versus CFC-BDP 1500 μg (n = 71) | 6 months | Symptoms Pulmonary function tests |
Onset of the first exacerbation tended to occur later and asthma symptoms tended to decrease while treated with HFA-BDP. Similar pulmonary function. Similar systemic safety. |
| Barnes et al89 | Large primary care database for asthma patients | HFA-BDP (n = 3140) versus CFC-BDP (n = 9162) | 1 year | Asthma control Exacerbation rate | Patients receiving HFA-BDP are more likely to achieve asthma control. |
| Huchon et al90 | 645 uncontrolled moderate-to-severe asthma | HFA-BDP 200 μg/formoterol 12 μg bid (fixed combination) versus CFC-BDP 500 μg bid and formoterol 12 μg bid, or CFC-BDP 500 μg bid | 24 weeks | Primary outcome: morning PEF Secondary outcomes: pulmonary function test symptoms, control, exacerbations |
Similar improvements in PEF while using single inhaler HFA-BDP/formoterol or while using separate traditional inhalers. HFA-BDP/formoterol was superior for asthma control and also with reference to the percentage of symptom-free days. |
| Müller et al91 | 111 moderate-to-severe asthma | HFA-BDP/formoterol (n = 53) versus FP/ salmeterol (n = 25) or BUD/formoterol (n = 33) | Cross-sectional real-life study | Asthma control | Better asthma control total score, daytime symptom score, and rescue medication use score; lower mean daily ICS dose while treated with HFA-BDP/formoterol. |
Abbreviations: CFC, chlorofluorocarbon; BDP, beclomethasone dipropionate; HFA, hydrofluoroalkane; AQLQ, Asthma Quality of Life Questionnaire; BUD, budesonide; FEV1, forced expiratory volume in one second; PEF, peak expiratory flow; COPD, chronic obstructive pulmonary disease; bid, twice a day; FP, fluticasone propionate; ICS, inhaled corticosteroids.