Beclomethasone for chronic asthma

A Cochrane review «Beclomethasone versus placebo for chronic asthma»1 «Adams NP, Bestall JC, Malouf R, Lasserson TJ, Jone...»1 on the efficacy of beclomethasone dipropionate (BDP) compared with placebo included 60 studies with a total of 6 542 subjects, both adults and children. The drug was well tolerated and the safety profile was comparable with placebo. BDP with CFC propellant (57 studies) at doses of 400 μg/day or less produced significant improvements from baseline in a number of efficacy measures compared with placebo in non-oral steroid treated patients: FEV₁ 360 ml (95% CI 260 to 460); FEV₁ (% predicted) WMD 12.41% (95% CI 8.18 to 16.64); morning PEF WMD 35.95 l/min (95% CI 27.85 to 44.04); reduction in rescue beta-2 agonist use –2.32 puffs/d (95% CI –2.55 to –2.09); reduction in the relative risk of trial withdrawal due to an asthma exacerbation RR 0.25 (95% CI 0.12 to 0.51). In oral steroid treated patients BDP led to significantly greater reductions in oral prednisolone use (WMD –4.91 mg/d; 95% CI –5.88 to –3.94 mg/d) and greater likelihood of withdrawing oral steroid treatment (RR 8.02; 95% CI 3.23 to 19.92). BDP with HFA propellant (3 studies) was significantly more effective than placebo in non-oral steroid-treated patients in improving FEV₁, morning and evening PEF, FEF25 to 75%, reduced asthma symptoms and beta2-agonists daily consumption. In oral steroid treated patients, HFA-BDP improved significantly FEV₁ and morning PEF.