To the Editor:
Bousquet et al. 1 recently compared the efficacy and safety of mometasone furoate dry powder inhaler (MF DPI) and budesonide DPI (Turbuhaler®) for the treatment of moderate persistent asthma. They concluded that lower doses of MF DPI appeared to be more effective than a clinically recommended dose of budesonide DPI, while providing a comparable degree of safety.
For several reasons we do not agree with this conclusion. Experiences gained during the last decade have taught us that the greatest amount of care must be taken in the design of studies where the relative efficacy of inhaled steroids are to be investigated. Not least has it repeatedly been seen that the dose-response curves for these drugs on most antiasthma variables are very flat, which means that traditional dose-response studies are acceptable for comparisons of relative efficacy only if several doses are selected over a wide dose range 2 …