Ciclesonide is more effective than budesonide in the treatment of persistent asthma

Abstract

Background: Ciclesonide is a lung-activated inhaled corticosteroid that provides effective control of persistent asthma. The objective of this study was to compare the efficacy and safety of once-daily ciclesonide versus once-daily budesonide in patients with asthma. Methods:A total of 399 patients with asthma were randomised to receive once-daily ciclesonide 320 µg ex-actuator (equivalent to 400 µg ex-valve) or once-daily budesonide 400 µg for 12 weeks. The primary endpoint was forced expiratory volume in 1 second (FEV 1 ). Additional efficacy variables included forced vital capacity (FVC), peak expiratory flow (PEF), asthma symptoms, use of rescue medication and time to onset of effect. Adverse events were monitored throughout the study. Conclusion:Once-daily ciclesonide was more effective than once-daily budesonide in improving FEV 1 , FVC and PEF. Ciclesonide also had an earlier onset of action than budesonide in patients with persistent asthma. Both ciclesonide and budesonide had good safety and tolerability profiles.

Treatment of the bronchial tree from beginning to end: targeting small airway inflammation in asthma

“…So far, most clinical studies with HFA‐ciclesonide have focused on standard lung function parameters such as FEV 1 or peak flow. In these studies, HFA‐ciclesonide showed similar efficacy to fluticasone propionate (FP) or budesonide . Interestingly, when looking at other parameters such as exhaled NO or QoL, HFA‐ciclesonide showed better results than FP.…”

Relevance of pharmacokinetics and pharmacodynamics of inhaled corticosteroids to asthma

“…The efficacy of once-daily dosing with ciclesonide has been indicated in a number of clinical trials in children, adolescents and adults with asthma in comparison with placebo, BUD and FP [78][79][80][81]. Furthermore, several clinical trials have demonstrated a low incidence of oropharyngeal candidiasis and no appreciable adverse effect on endogenous cortisol secretion after short-and long-term treatment of asthma with ciclesonide at doses ranging 80-1,280 mg (ex-actuator) [82][83][84][85][86][87][88].…”

Chronotherapeutics — A chronopharmaceutical approach to drug delivery in the treatment of asthma

“…From the studies it was found that once-daily ciclesonide is more effective than once-daily budesonide in improving FEV 1 , FVC and PEF. Ciclesonide also had an earlier onset of action than budesonide in patients with persistent asthma [56].…”