At the smaller dose, the new drug fluticasone was just as effective as beclomethasone and budesonide at opening up constricted breathing passages, according to review author Dr. Nick Adams, a private practitioner in Tonbridge, England, and colleagues.
Patients taking the three drugs had similar rates of "rescue" inhaler use, the researchers found. Rescue inhaler medications such as albuterol are used to immediately open the lung's airways during an asthma attack. Fluticasone, beclomethasone and budesonide prevent and reduce the severity of asthma attacks over a longer period of time.
The studies did not contain enough information to determine how any of the drugs affected asthma symptoms like wheezing and shortness of breath or whether any of the treatments led to more severe asthma attacks.
"A clear recommendation for fluticasone over the older agents cannot be made on the basis of every outcome from this review, but in the most severe patients fluticasone may confer an advantage over beclomethasone or budesonide," Adams and colleagues write.
The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
Fluticasone, beclomethasone and budesonide are inhaled corticosteroid drugs that decrease airway swelling and irritation in asthma patients. Fluticasone is sold under the brand name Flovent and is an ingredient in the combination asthma medication Advair. Beclomethasone is sold under the brand names Beconase, QVAR and Vanceril. Budesonide is sold under the brands Pulmicort and Rhinocort.<
Contact: Nick Adams
Center for the Advancement of Health