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Post‐inhalation bronchoconstriction by beclomethasone dipropionate: A comparison of two different CFC propellant formulations in asthmatics
Author(s) -
Ruffin Richard E.,
Campbell Donald A.,
Chia Mon M.
Publication year - 2000
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1046/j.1440-1843.2000.00238.x
Subject(s) - bronchoconstriction , chlorofluorocarbon , medicine , inhalation , asthma , anesthesia , beclometasone dipropionate , propellant , population , adverse effect , cumulative dose , respiratory disease , lung , chemistry , physics , environmental health , organic chemistry , meteorology
Objective : To assess the change in bronchial response to cumulative doses from two beclomethasone dipropionate metered‐dose inhalers (MDI), each using chlorofluorocarbon (CFC) propellants, in asthma patients previously showing falls in forced expiratory volume in 1 s (FEV 1 ) shortly after exposure to beclomethasone MDI. Methodology : A total of 18 patients were randomized to a single‐blind, three‐period cross‐over treatment regimen, whereby each was administered increasing doses of control mixture (containing surfactant and CFC propellants) or beclomethasone, formulated as either Becloforte™ or Respocort™ (250–1000 μg per dose; cumulative dose 2000 μg). Bronchial response was measured by comparison of FEV 1 values pre‐ and post‐inhalation. Results : Respocort formulation produced the least post‐dose mean maximum reduction in FEV 1 (0.36 ± 0.17 L; 14.3 ± 7.2% of baseline FEV 1 ), while the reduction caused by the control was similar (0.40 ± 0.18 L; 16.2 ± 9.9% of baseline FEV 1 ). Becloforte produced a significantly greater maximum reduction in FEV 1 than Respocort (0.55 ± 0.32 L, P = 0.003; 22.0 ± 15.3% of baseline FEV 1 , P = 0.005). No serious adverse events were reported, but four patients experienced falls in FEV 1 of greater than 15% (three on Becloforte, one using the control). Conclusion : The incidence of falls in FEV 1 following use of beclomethasone MDI was low and generally not serious even in a selected population. The Becloforte preparation produced significantly more post‐dose bronchoconstriction than the Respocort formulation, perhaps because of differences in the composition of the surfactant and/or CFC propellant mixtures used to formulate each of the aerosols.