Fluticasone given once versus twice a day: meta-analysis.

Area of Science:

• Pulmonology
• Clinical Pharmacology
• Evidence-Based Medicine

Background:

• Inhaled corticosteroids (ICS) are a cornerstone of asthma management.
• Optimal dosing frequency for ICS, such as fluticasone, is crucial for therapeutic efficacy.
• Previous studies have explored various fluticasone administration schedules.

Purpose of the Study:

• To compare the clinical efficacy of once-daily versus twice-daily administration of fluticasone in patients with asthma.
• To evaluate the impact of dosing frequency on lung function and treatment adherence.

Main Methods:

• A meta-analysis of randomized, double-blind trials was conducted.
• Included studies had a minimum duration of 4 weeks and compared once-daily to twice-daily fluticasone.
• Clinical outcome measures, including lung function and treatment withdrawals, were analyzed.

Main Results:

• Six studies involving 1517 participants (children and adults) met the criteria.
• Twice-daily fluticasone demonstrated significantly greater efficacy across most outcome measures compared to once-daily dosing.
• Improvements in FEV(1) and peak expiratory flow were observed with twice-daily administration.
• Significantly fewer participants withdrew from treatment due to asthma with twice-daily fluticasone (OR 0.44).

Conclusions:

• Twice-daily administration of fluticasone offers greater therapeutic benefit for asthma control.
• This dosing regimen is associated with improved lung function and better treatment adherence.
• Findings support twice-daily fluticasone over a once-daily morning regimen for enhanced asthma management.