A Cochrane review [Abstract] 1 on the efficacy of beclomethasone dipropionate (BDP) compared with placebo included 60 studies with a total of 6 542 subjects, both adults and children. The drug was well tolerated and the safety profile was comparable with placebo. BDP with CFC propellant (57 studies) at doses of 400 μg/day or less produced significant improvements from baseline in a number of efficacy measures compared with placebo in non-oral steroid treated patients: FEV1 360 ml (95% CI 260 to 460); FEV1 (% predicted) WMD 12.41% (95% CI 8.18 to 16.64); morning PEF WMD 35.95 l/min (95% CI 27.85 to 44.04); reduction in rescue beta-2 agonist use -2.32 puffs/d (95% CI -2.55 to -2.09); reduction in the relative risk of trial withdrawal due to an asthma exacerbation RR 0.25 (95% CI 0.12 to 0.51). In oral steroid treated patients BDP led to significantly greater reductions in oral prednisolone use (WMD -4.91 mg/d; 95% CI -5.88 to -3.94 mg/d) and greater likelihood of withdrawing oral steroid treatment (RR 8.02; 95% CI 3.23 to 19.92). BDP with HFA propellant (3 studies) was significantly more effective than placebo in non-oral steroid-treated patients in improving FEV1, morning and evening PEF, FEF25 to 75%, reduced asthma symptoms and beta2-agonists daily consumption. In oral steroid treated patients, HFA-BDP improved significantly FEV1 and morning PEF.
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