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Inhaled beclomethasone versus placebo for chronic asthma
N P Adams1, J B Bestall, P W Jones
1Dept Physiological Medicine, St George's Hospital Medical School, Cranmer Terrace, London, UK, SW17 ORE. nadams@sghms.ac.uk
The Cochrane Database of Systematic Reviews
|October 18, 2000
Summary
Inhaled beclomethasone dipropionate (BDP) significantly improves asthma control and reduces medication needs compared to placebo. Evidence suggests limited benefit for dose titration above 400 mcg/day in mild to moderate asthma.
Area of Science:
- Pulmonology
- Pharmacology
- Clinical Medicine
Background:
- Inhaled beclomethasone dipropionate (BDP) is a primary anti-inflammatory treatment for asthma.
- Newer asthma therapies are often compared against BDP as a reference standard.
Purpose of the Study:
- To compare the efficacy of BDP against placebo in chronic asthma treatment.
- To investigate potential dose-response relationships for BDP.
- To establish BDP efficacy as a benchmark for new asthma treatments.
Main Methods:
- Systematic review of randomized controlled trials comparing BDP to placebo.
- Searched Cochrane Airways Group Trial Register and contacted trialists.
- Assessed 52 studies involving 3459 subjects for inclusion and quality.
Main Results:
- BDP significantly improved lung function (FEV1, PEFR) and reduced rescue medication use versus placebo.
- In oral steroid users, BDP reduced prednisolone use and increased discontinuation rates.
- Limited evidence for dose-response effects above 400 mcg/day in mild/moderate asthma.
Conclusions:
- The review strongly supports the efficacy of BDP in treating chronic asthma.
- Dose titration above 400 mcg/day lacks strong support for mild to moderate asthma.
- Insufficient data exists for dose-response conclusions in severe asthma.