Inhaled mometasone furoate reduces oral prednisone usage and improves lung function in severe persistent asthma.

Abstract

OBJECTIVE:

The reduction of oral prednisone use by mometasone furoate (MF) delivered by HFA-227 metered dose inhaler (MDI) was examined in oral corticosteroid (OCS)-dependent patients with severe persistent asthma.

METHODS:

A 3-month, double-blind, placebo-controlled clinical trial (n=123), followed by a 9-month open-label phase (n=120). The study was conducted at 26 medical centers in the United States. Patients were randomized to treatment with MF-MDI 400 or 800 microg twice-daily (bid) doses, or placebo in the double-blind trial. All patients received MF in the open-label phase.

RESULTS:

At the endpoint of the double-blind trial, MF-MDI 400 and 800 microg bid reduced the daily OCS dose by 39.4% and 31.1%, respectively, while placebo increased the OCS dose by 107.2% (P<0.01). The OCS requirement was reduced by 50% or more in 63% and 60% of patients treated with MF-MDI 400 and 800 microg bid, respectively, compared with 14% of patients receiving placebo. After 12 weeks, despite prednisone reductions, pulmonary function, asthma symptoms, albuterol use, nocturnal awakenings, and physician-evaluated response to therapy also showed significant improvement with MF-MDI treatment compared with placebo. Further reductions in OCS requirements were achieved with long-term MF-MDI treatment in the open-label phase, with an overall 67% reduction in prednisone usage and 51% of patients completely eliminating prednisone usage by the 1-year time point.

CONCLUSION:

MF delivered by HFA-227 MDI significantly reduces daily OCS use compared with placebo and facilitates elimination of OCS use in patients with severe persistent asthma.

• Authors: Jill P Karpel, Anjuli Nayak, William Lumry, Timothy J Craig, Edward Kerwin, James E Fish, Barry Lutsky
• Journal: Respiratory medicine (Respir Med) Vol. 101 Issue 3 Pg. 628-37 (Mar 2007) ISSN: 0954-6111 [Print] England
• PMID: 16875813 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Inflammatory Agents
• Glucocorticoids
• Pregnadienediols
• Mometasone Furoate
• Prednisone

Topics

• Administration, Inhalation
• Administration, Oral
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Inflammatory Agents (administration & dosage, adverse effects)
• Asthma (drug therapy, physiopathology)
• Double-Blind Method
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Glucocorticoids (administration & dosage)
• Humans
• Lung (drug effects, physiopathology)
• Male
• Metered Dose Inhalers
• Middle Aged
• Mometasone Furoate
• Prednisone (administration & dosage)
• Pregnadienediols (administration & dosage, adverse effects)
• Quality of Life
• Treatment Outcome