engleski

Comparison of inhaled ciclesonide, fluticasone propinate and fluticasone propionate + salmeterol in maintaining asthma control

Ciclesonide (CIC) is an inhaled corticosteroid with high anti-inflammatory activity. The first objective of this study was to compare efficacy of CIC, fluticasone propionate (FP) and fluticasone propionate + salmeterol in children with persistent asthma. Second objective was to compare CIC as a step-down approach in well-controlled asthma patients, as recommended by guidelines, from FP (100 mcg) + salmeterol (50 mcg) twice daily to ciclesonide 160mcg daily. A total of 62 children aged 12 to 18 years with asthma were treated 1-6 years with FP or FP + salmeterol prior to introducing CIC. They were divided into two groups ; one group was taking 200 mcg FP daily, second FP (200 mcg daily) with salmeterol (100 mcg daily) prior to introducing CIC. Spirometry performed year before and one year after introducing CIC was matched for statistical analysis. ACT test one year before and one year after introducing ciclesonide was compared in both treatment groups. A statistically significant increase from baseline was observed in FEV 1 (4, 4% predicted) and PEF (8, 6% predicted) (P<0.001 for both) for CIC in both groups. There was no change in use of rescue medication and number of exacerbations in both groups. ACT test score showed statistically significant increase (0, 6) (P 0.02) one year after starting ciclesonide in both groups. The efficacy of CIC 160 mcg daily was comparable to FP 200 mcg daily regarding number exacerbations and use of rescue medications with better spirometry levels (FEV 1 and PEF). Patients well controlled on FP + salmeterol who were stepped down to CIC160, maintained similar asthma control and better spirometry levels (FEV 1 and PEF).

asthma; children; inhaled corticosteroid

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