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Treatment of exercise-induced asthma with beclomethasone dipropionate in children with asthma

Dept of Paediatrics, Kolding Hospital, Kolding, Denmark

CORRESPONDENCE: R. Petersen, Dept of Paediatrics, Kolding Hospital, 6000 Kolding, Denmark. Fax: 45 75535222. E-mail: sumsar68@hotmail.com

Keywords: Asthma, children, dose response, exercise, hydrofluoroalkane-beclomethasone dipropionate, nitric oxide

Received: December 23, 2003
Accepted July 23, 2004

This study was supported by 3M Pharmaceuticals, St. Paul, MN, USA.

A new hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) aerosol markedly increases drug delivery to the airways. Therefore, even low doses of HFA-BDP should be effective, and the present study assesses this.

A randomised, double-blind, crossover study was used to compare the effect of placebo, HFA-BDP 50 µg or 100 µg given q.d. (QVAR^TM Autohaler^TM; 3M Pharmaceuticals, St. Paul, MN, USA) on exercise-induced bronchoconstriction and exhaled nitric oxide (eNO). After a 14-day run-in, 25 children (5–14 yrs old) entered three 4-week treatment periods, separated by a 1-week washout. After each period, the fall in forced expiratory volume in one second (FEV₁), after an exercise test, and eNO were measured.

Significant treatment effects with no carry-over or period effects were seen for both eNO and maximum fall in FEV₁ after exercise. Differences were seen between placebo (fall in FEV₁=27.9%; eNO=14.4 parts per billion (ppb)) and either dose of HFA-BDP, but not between the two active doses (50 µg: fall in FEV₁=20.8%, eNO=9.3 ppb; 100 µg: fall in FEV₁=20.9%, eNO=8.9 ppb).

In conclusion, low q.d. doses of hydrofluoroalkane-beclomethasone dipropionate reduced exhaled nitric oxide and exercise-induced bronchoconstriction. Further studies are needed to assess whether q.d. administration of beclomethasone dipropionate is as effective as b.i.d. administration.

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