Minimum dose requirements of steroid-dependent asthmatic patients for aerosol beclomethasone and oral prednisone

Toogood, J.H.; Lefcoe, Neville M.; Haines, D. S. M.; Chuang, L.; Jennings, Barbara; Errington, N.; Baksh, L.; Cauchi, Matthew

doi:10.1016/0091-6749(78)90114-8

Cited by 50 publications

(3 citation statements)

References 32 publications

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“…No significant difference between the effects of adjacent doses was seen. At a later stage in the study, the patients were able to progressively reduce their dose of oral steroid, revealing an apparent doseresponse for the oral steroid-sparing effect of the inhaled BDP (157), but again with little difference between individual dose steps.…”

Section: Beclomethasone Dipropionatementioning

confidence: 95%

Efficacy and Safety of Inhaled Corticosteroids

Barnes

Pedersen

Busse

1998

Am J Respir Crit Care Med

701

406

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Section: Beclomethasone Dipropionatementioning

confidence: 95%

Efficacy and Safety of Inhaled Corticosteroids

Barnes

Pedersen

Busse

1998

Am J Respir Crit Care Med

701

406

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“…Initial dose-response curves were obtained mainly in this patient population, using both BDP and BUD in the recommended therapeutic dose range (54,55). In addition to the evaluation of the dose-response effects on lung function, such studies were also used to assess dose response in relation to oral GCS-sparing efficacy (56), to compare the effects of different dosing frequency (57), to evaluate the efficacy of different inhaler devices (58), and to calculate dose ratios between inhaled GCS and oral prednisone (59). The mean dose-response curves in these studies were usually relatively flat, with a marked effect of the lowest dose and only minor and insignificant differences between the effects of adjacent doses of GCS.…”

Section: Measuring Clinical Effects Of Gcss In Asthmamentioning

confidence: 99%

A comparison of the efficacy and safety of inhaled corticosteroids in asthma

Pedersen

O’Byrne

1997

Allergy

269

169

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“…Furthermore, 28 of the 34 patients in the group had to supplement their BDP intermittently with one or more courses of oral steroid during the last six months of an 18 month clinical follow-up. 14 The success rate for totally replacing oral prednisone with inhaled BDP may be improved in such patients ifhigher doses of inhaled steroid were used (Figures 2,3). It is feasible to use such doses in those parts of Europe where concentrated formulations of BDP or BUD are currently available for clinical use; however, it is not feasible in America where inhaled steroids are available only in a single concentration that delivers a low dose ego 50 ug BDP jpuff.…”

Section: Concurrent Usagementioning

confidence: 97%

Efficiency of Inhaled Versus Oral Steroid Treatment of Chronic Asthma

Toogood¹

1987

allergy asthma proc

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The therapeutic efficiency of oral vs. inhaled steroid treatment for chronic asthma was compared in several graded-dose. double-blind controlled trials. Inhaled steroid proved significantly more effective than alternate-morning prednisone when the two regimens were compared in the same patients at equivalent levels of systemic glucocorticoid activity. Furthermore. if given in sufficient dosage, inhaled steroids proved equally as effective as oral prednisone given daily. and better tolerated than the latter. The data support a broadening of the therapeutic role of inhaled steroid drugs to include higher dosages and patients with more severe grades of asthma. To facilitate this, concentratedformulations are needed. Until the latter become available to the practitioner. combinations of inhaled plus oral steroid treatment may be used. since these have been shown to improve the efficacy of chronic steroid therapy without worsening its adverse effects.98 not applicable to the treatment of patients with relatively severe chronic asthma. Furthermore, since doses of BDP greater than -I mg/day (or comparable doses of other inhaled steroids) show measurable systemic glucocorticoid activity, the use of high doses of these drugs is thought to confer no advantage over oral steroid in the treatment of severe asthmatics. Both these concepts are at odds with some observations made during several recent studies in whicl1 the clinical performance of oral prednisone was compared with that of the inhaled steroid, budesonide. Budesonide (BUD) is a topically active corticosteroid similar to BDP, but with a more favorable ratio of antiasthmatic to systemic activity.'Alternate-day Prednisone vs. Inhaled Budesonide B efore inhaled steroid therapy was introduced to America, low dose alternate-morning prednisone was the preferred steroid regimen for chronic asthma treatment. Its efficacy was established, and it had been shown to cause fewer adverse effects than divided dose or daily single-dose prednisone. 2 - 6 After a decade of clinical experience with BDP some uncertainty persists, particularly among American pediatricians, as to whether inhaled steroid drugs afford a clinically important advantage over low dose alternate-morning prednisone.2.8·9 A rationale has been proposed for considering the latter as the treatment of choice for many patients who need maintenance steroid therapy.2 The basis for this view is a perception that the two regimens are about equally effective; the observation that either may show evidence of systemic glucocorticoid activity at low dosage in some patients, if sufficiently sensitive tests of

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Minimum dose requirements of steroid-dependent asthmatic patients for aerosol beclomethasone and oral prednisone

Cited by 50 publications

References 32 publications

Efficacy and Safety of Inhaled Corticosteroids

Efficacy and Safety of Inhaled Corticosteroids

A comparison of the efficacy and safety of inhaled corticosteroids in asthma

Efficiency of Inhaled Versus Oral Steroid Treatment of Chronic Asthma

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