Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma

N. Scichilone, S. Battaglia, C. Sorino, G. Paglino, L. Martino, A. Paternò, R. Santagata, M. Spatafora, G. Nicolini, V. Bellia

Research output: Contribution to journalArticle

Abstract

Background: Airway inflammation in asthma involves both large and small airways, and the combination of inhaled corticosteroids (ICS) and long acting beta-2 agonists (LABA) is the mainstay of therapy. Available inhaled combinations differ in terms of drug delivery to the lung and the ability to reach small airways. Aim: To evaluate whether treatment with an extra-fine inhaled combination provides additional effects vs a nonextra-fine combination on airway function. Methods: After a 1- to 4-week run-in period, patients with asthma were randomized to a double blind, double dummy, 12-week treatment with either extra-fine beclomethasone/formoterol (BDP/F) 400/24 μg daily or fluticasone propionate/salmeterol (FP/S) 500/100 μg daily. Methacholine (Mch) bronchoprovocation challenge and single breath nitrogen (sbN2) test were performed. Results: Thirty patients with asthma (15 men), mean age 43, mean forced expiratory volume in the first second (FEV1) 71.4% of predicted, were included. A significant increase (P <0.01) versus baseline was observed in predose FEV1 in both BDP/F and FP/S groups (0.37 ± 0.13 l and 0.36 ± 0.12 l, respectively). PD20FEV 1 Mch improved significantly from 90.42 (±30.08) μg to 432.41 (±122.71) μg in the BDP/F group (P = 0.01) but not in the FP/S group. A trend toward improvement vs baseline was observed for BDP/F in closing capacity (CC), whereas no differences were recorded in other sbN2 test parameters. Conclusion: The findings of this pilot study suggest that an extra-fine inhaled combination for the treatment of asthma has beneficial effects on both large and small airways function as expressed by Mch and sbN2 tests.

Original languageEnglish (US)
Pages (from-to)897-902
Number of pages6
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume65
Issue number7
DOIs
StatePublished - 2010
Externally publishedYes

Fingerprint

Beclomethasone
Methacholine Chloride
Asthma
Forced Expiratory Volume
Therapeutics
Adrenal Cortex Hormones
Nitrogen
Inflammation
Lung
Formoterol Fumarate
Pharmaceutical Preparations
Salmeterol Xinafoate Drug Combination Fluticasone Propionate

Keywords

  • Asthma
  • Extra-fine formulation
  • Methacholine
  • Nitrogen test
  • Small airways

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Medicine(all)

Cite this

Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma. / Scichilone, N.; Battaglia, S.; Sorino, C.; Paglino, G.; Martino, L.; Paternò, A.; Santagata, R.; Spatafora, M.; Nicolini, G.; Bellia, V.

In: Allergy: European Journal of Allergy and Clinical Immunology, Vol. 65, No. 7, 2010, p. 897-902.

Research output: Contribution to journalArticle

Scichilone, N, Battaglia, S, Sorino, C, Paglino, G, Martino, L, Paternò, A, Santagata, R, Spatafora, M, Nicolini, G & Bellia, V 2010, 'Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma', Allergy: European Journal of Allergy and Clinical Immunology, vol. 65, no. 7, pp. 897-902. https://doi.org/10.1111/j.1398-9995.2009.02306.x
Scichilone, N. ; Battaglia, S. ; Sorino, C. ; Paglino, G. ; Martino, L. ; Paternò, A. ; Santagata, R. ; Spatafora, M. ; Nicolini, G. ; Bellia, V. / Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma. In: Allergy: European Journal of Allergy and Clinical Immunology. 2010 ; Vol. 65, No. 7. pp. 897-902.
@article{89206768e91e4f23b3f8d65a42817cbc,
title = "Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma",
abstract = "Background: Airway inflammation in asthma involves both large and small airways, and the combination of inhaled corticosteroids (ICS) and long acting beta-2 agonists (LABA) is the mainstay of therapy. Available inhaled combinations differ in terms of drug delivery to the lung and the ability to reach small airways. Aim: To evaluate whether treatment with an extra-fine inhaled combination provides additional effects vs a nonextra-fine combination on airway function. Methods: After a 1- to 4-week run-in period, patients with asthma were randomized to a double blind, double dummy, 12-week treatment with either extra-fine beclomethasone/formoterol (BDP/F) 400/24 μg daily or fluticasone propionate/salmeterol (FP/S) 500/100 μg daily. Methacholine (Mch) bronchoprovocation challenge and single breath nitrogen (sbN2) test were performed. Results: Thirty patients with asthma (15 men), mean age 43, mean forced expiratory volume in the first second (FEV1) 71.4{\%} of predicted, were included. A significant increase (P <0.01) versus baseline was observed in predose FEV1 in both BDP/F and FP/S groups (0.37 ± 0.13 l and 0.36 ± 0.12 l, respectively). PD20FEV 1 Mch improved significantly from 90.42 (±30.08) μg to 432.41 (±122.71) μg in the BDP/F group (P = 0.01) but not in the FP/S group. A trend toward improvement vs baseline was observed for BDP/F in closing capacity (CC), whereas no differences were recorded in other sbN2 test parameters. Conclusion: The findings of this pilot study suggest that an extra-fine inhaled combination for the treatment of asthma has beneficial effects on both large and small airways function as expressed by Mch and sbN2 tests.",
keywords = "Asthma, Extra-fine formulation, Methacholine, Nitrogen test, Small airways",
author = "N. Scichilone and S. Battaglia and C. Sorino and G. Paglino and L. Martino and A. Patern{\`o} and R. Santagata and M. Spatafora and G. Nicolini and V. Bellia",
year = "2010",
doi = "10.1111/j.1398-9995.2009.02306.x",
language = "English (US)",
volume = "65",
pages = "897--902",
journal = "Allergy: European Journal of Allergy and Clinical Immunology",
issn = "0105-4538",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma

AU - Scichilone, N.

AU - Battaglia, S.

AU - Sorino, C.

AU - Paglino, G.

AU - Martino, L.

AU - Paternò, A.

AU - Santagata, R.

AU - Spatafora, M.

AU - Nicolini, G.

AU - Bellia, V.

PY - 2010

Y1 - 2010

N2 - Background: Airway inflammation in asthma involves both large and small airways, and the combination of inhaled corticosteroids (ICS) and long acting beta-2 agonists (LABA) is the mainstay of therapy. Available inhaled combinations differ in terms of drug delivery to the lung and the ability to reach small airways. Aim: To evaluate whether treatment with an extra-fine inhaled combination provides additional effects vs a nonextra-fine combination on airway function. Methods: After a 1- to 4-week run-in period, patients with asthma were randomized to a double blind, double dummy, 12-week treatment with either extra-fine beclomethasone/formoterol (BDP/F) 400/24 μg daily or fluticasone propionate/salmeterol (FP/S) 500/100 μg daily. Methacholine (Mch) bronchoprovocation challenge and single breath nitrogen (sbN2) test were performed. Results: Thirty patients with asthma (15 men), mean age 43, mean forced expiratory volume in the first second (FEV1) 71.4% of predicted, were included. A significant increase (P <0.01) versus baseline was observed in predose FEV1 in both BDP/F and FP/S groups (0.37 ± 0.13 l and 0.36 ± 0.12 l, respectively). PD20FEV 1 Mch improved significantly from 90.42 (±30.08) μg to 432.41 (±122.71) μg in the BDP/F group (P = 0.01) but not in the FP/S group. A trend toward improvement vs baseline was observed for BDP/F in closing capacity (CC), whereas no differences were recorded in other sbN2 test parameters. Conclusion: The findings of this pilot study suggest that an extra-fine inhaled combination for the treatment of asthma has beneficial effects on both large and small airways function as expressed by Mch and sbN2 tests.

AB - Background: Airway inflammation in asthma involves both large and small airways, and the combination of inhaled corticosteroids (ICS) and long acting beta-2 agonists (LABA) is the mainstay of therapy. Available inhaled combinations differ in terms of drug delivery to the lung and the ability to reach small airways. Aim: To evaluate whether treatment with an extra-fine inhaled combination provides additional effects vs a nonextra-fine combination on airway function. Methods: After a 1- to 4-week run-in period, patients with asthma were randomized to a double blind, double dummy, 12-week treatment with either extra-fine beclomethasone/formoterol (BDP/F) 400/24 μg daily or fluticasone propionate/salmeterol (FP/S) 500/100 μg daily. Methacholine (Mch) bronchoprovocation challenge and single breath nitrogen (sbN2) test were performed. Results: Thirty patients with asthma (15 men), mean age 43, mean forced expiratory volume in the first second (FEV1) 71.4% of predicted, were included. A significant increase (P <0.01) versus baseline was observed in predose FEV1 in both BDP/F and FP/S groups (0.37 ± 0.13 l and 0.36 ± 0.12 l, respectively). PD20FEV 1 Mch improved significantly from 90.42 (±30.08) μg to 432.41 (±122.71) μg in the BDP/F group (P = 0.01) but not in the FP/S group. A trend toward improvement vs baseline was observed for BDP/F in closing capacity (CC), whereas no differences were recorded in other sbN2 test parameters. Conclusion: The findings of this pilot study suggest that an extra-fine inhaled combination for the treatment of asthma has beneficial effects on both large and small airways function as expressed by Mch and sbN2 tests.

KW - Asthma

KW - Extra-fine formulation

KW - Methacholine

KW - Nitrogen test

KW - Small airways

UR - http://www.scopus.com/inward/record.url?scp=77953090892&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953090892&partnerID=8YFLogxK

U2 - 10.1111/j.1398-9995.2009.02306.x

DO - 10.1111/j.1398-9995.2009.02306.x

M3 - Article

C2 - 20121764

AN - SCOPUS:77953090892

VL - 65

SP - 897

EP - 902

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

SN - 0105-4538

IS - 7

ER -