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Evidence summaries

Fluticasone Versus Hfa-Beclomethasone Dipropionate for Chronic Asthma

There appears to be no significant difference in the effect between inhaled fluticasone versus extra fine HFA-propelled beclomethasone dipropionate on FEV1 in adults with chronic asthma. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 9 studies, with a total of 1 265 subjects, on the relative efficacy of fluticasone and HFA-propelled beclomethasone (BDP) in chronic asthma. Two studies were conducted in children. HFA (hydrofluoroalkane-134a) is a new CFC-free propellant. Lung function was not significantly different between extra fine beclomethasone and fluticasone when compared at the same dose in parallel studies; change in FEV1: 0.04 litres (95% CI -0.03 to 0.11 litres; three studies, 659 adults); change in FEV1 predicted: -2.18% (95% CI -4.62 to 0.26; three studies, 334 adults); change in morning PEF: -0.69 litres (95% CI -11.21 to 9.83 litres; I2 70%; two studies, 364 adults). Individual studies reported non-significant findings in symptom scores and quality of life questionnaires. There was no significant difference in the risk of study withdrawal, dysphonia or any reported adverse event.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding).

    References

    • Lasserson TJ, Cates CJ, Jones A-B, Lasserson EH, White J. Fluticasone versus HFA-beclomethasone dipropionate for chronic asthma in adults and children. Cochrane Database Syst Rev. 2006;(2):CD005309 [Review content assessed as up-to-date: 12 January 2010].

Primary/Secondary Keywords