Mometazone Reduces Oral Prednisone Requirements in Severe Asthma

November 11, 2002

Peggy Peck

Nov. 11, 2002 (San Diego) — In a study of patients with chronic, severe asthma, mometazone furoate administered by metered dose inhaler effectively reduced oral prednisone requirements to levels significantly lower than the minimum effective doses achieved with other inhaled corticosteroids (ICS).

The results were presented here at CHEST 2002, the 68th annual meeting of the American College of Chest Physicians.

Jill P. Karpel, MD, from Montefiore Medical Center, Bronx, New York, said mometasone furoate (MF) was administered by hydrofluoroalkane (HFA)-227 metered dose inhaler (MDI).

A total of 128 patients were recruited for the 12-week, multicenter, parallel group, double-blind, placebo-controlled study. The minimal effective dose of oral prednisone achievable with other ICS was determined for each patient prior to randomization. Patients were then randomized to treatment groups that received MF-MDI 400 µg twice daily, MF-MDI 800 µg twice daily, or placebo.

Each patient was assessed at weekly intervals according to a series of conservative criteria to determine their eligibility for prednisone dose reduction.

At endpoint, the mean daily prednisone dose was significantly reduced ( P<.01) from the minimum effective dose established at baseline for patients given MF-MDI 400 µg twice daily (–39%) or MF-MDI 800 µg twice daily (–31%) compared with an increase in prednisone dose for patients given placebo (+107%).

Sandra K. Willsie, DO, dean of the University of Health Sciences College of Osteopathic Medicine in Kansas City, Missouri, said the study was well designed and "demonstrated impressive results for this approach to steroid sparing." She said, however, that the results need to be replicated in a larger study.

A breakdown of the results based on ICS medication used prior to the study indicated that prednisone use was reduced to similar extents regardless of whether patients had previously been using fluticasone propionate, beclomethasone dipropionate, or triamcinolone acetonide.

Karpel concluded that MF-MDI may be effective in reducing oral prednisone use in patients with severe persistent asthma who achieve limited success in reducing their oral corticosteroid use while receiving other ICS.

CHEST 2002: Abstract S182. Presented Nov. 6, 2002.

Reviewed by Gary D. Vogin, MD

Peggy Peck is a freelance writer for Medscape.

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