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Summary
Asthma patients experiencing cough and wheezing from beclomethasone dipropionate aerosol (BA) can often tolerate it with bronchodilator pretreatment. Some may require short oral steroid courses for severe side effects impacting compliance.
Area of Science:
- Pulmonology
- Allergy and Immunology
- Pharmacology
Background:
- Cough and wheezing are common side effects of beclomethasone dipropionate aerosol (BA) in asthma patients.
- Approximately 20% of outpatients cannot tolerate BA due to these adverse effects, impacting treatment adherence.
Purpose of the Study:
- To evaluate the efficacy of bronchodilator pretreatment in mitigating cough and wheezing side effects associated with BA inhalation.
- To determine alternative management strategies for patients unable to tolerate BA therapy.
Main Methods:
- A double-blind, crossover study involving 12 asthma patients with a history of severe cough and wheezing after BA.
- Patients received three puffs of either BA or placebo (Plc) via metered dose inhaler (MDI).
- Cough frequency and forced expiratory volume in one second (FEV1) were measured; albuterol was used as a pretreatment in some cases.
Main Results:
- Patients coughed significantly more after BA (mean 31 times) compared to placebo (mean 19 times).
- FEV1 declined similarly after both BA (22.6%) and placebo (22.0%).
- Pretreatment with albuterol attenuated both cough and FEV1 decline. Seven of 12 patients tolerated BA with regular bronchodilator pretreatment; five required oral steroids.
Conclusions:
- Bronchodilator pretreatment can effectively reduce BA-induced cough and wheezing in some asthma patients.
- For patients experiencing persistent side effects, a short course of oral steroids may be necessary to enable BA therapy.
- Managing these side effects is crucial for improving patient compliance with inhaled corticosteroid treatment.