Switch to non-CFC inhaled corticosteroids: a comparative efficacy study of HFA-BDP and CFC-BDP metered-dose inhalers

Inhaled corticosteroids, such as beclomethasone dipropionate (BDP), recommended for the treatment of persistent, mild, moderate, or severe asthma, have traditionally been administered via chlorofluorocarbon (CFC) propellant. The imminent phasing out of CFCs from pharmaceutical preparations due to the Montreal Protocol means patients will have to switch to a CFC-free alternative. One such preparation is hydrofluoroalkane-BDP (HFA-BDP), a press-and-breathe metered-dose inhaler. This 8-week, open-label, multicentre study assessed asthma control in patients switching from CFC-BDP to HFA-BDP (QVAR). Patients with asthma, stabilised on 400-1600 micrograms/day CFC-BDP, were randomised to HFA-BDP (354 patients; 75%) at half their current daily dose of CFC-BDP, or to CFC-BDP (119 patients; 25%). HFA-BDP efficacy was found to be equivalent to that of CFC-BDP in that no statistically significant difference was observed between the two groups in the mean change from baseline in a.m. PEF (95% CI within +/- 11 l/min). No statistically significant differences were observed between the two groups for increased asthma symptoms or acute asthma episodes. We conclude that asthma control was maintained over 8 weeks, with few asthma exacerbations, in patients switching from previous CFC-BDP therapy to HFA-BDP at half the dose.