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Inhaled fluticasone propionate for chronic asthma
N Adams1, J 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
|November 1, 2001
Summary
Inhaled fluticasone propionate (FP) effectively treats asthma by improving lung function and reducing symptoms. While higher doses offer greater benefits, even low doses provide significant improvements with increased risks of oropharyngeal side effects.
Area of Science:
- Pulmonology
- Pharmacology
Background:
- Inhaled fluticasone propionate (FP) is an inhaled corticosteroid used for asthma management.
- This review assesses FP's efficacy and safety in treating chronic asthma.
Purpose of the Study:
- To evaluate the effectiveness and safety of FP compared to placebo in chronic asthma patients.
- To investigate potential dose-response relationships for FP treatment.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searched multiple databases and trial registries for relevant studies published between 1997-1999.
- Included 28 studies with 5788 participants, assessing methodological quality.
Main Results:
- FP significantly improved lung function (FEV1, PEF) and reduced asthma symptoms and rescue medication use compared to placebo.
- A dose-response effect was observed, though improvements with lower doses were only slightly less than higher doses.
- High-dose FP reduced oral corticosteroid dependency, but increased the incidence of sore throat, hoarseness, and oral candidiasis.
Conclusions:
- FP doses of 100-1000 mcg/day are effective for mild-to-moderate asthma.
- While a dose-response exists, low-dose FP offers substantial benefits with fewer side effects.
- High-dose FP aids in reducing oral corticosteroid use, but oropharyngeal side effects are dose-dependent.