Comparison of dose-response effects of inhaled beclomethasone dipropionate and budesonide in the management of asthma

The dose-response effects of inhaled beclomethasone dipropionate (BDP) and budesonide (BUD) administered b.i.d. with the aid of metered dose aerosols were studied in 128 patients (67 men and 61 women, mean age 53 years) suffering from asthma bronchiale. The study was designed as a multi-centre, double-blind, four-period cross-over study, followed by a single-blind double placebo period. BDP was administered in doses of 400 and 1000 μg, and BUD in doses of 400 and 800 μg. The results in terms of peak expiratory flow (PEF) in the morning and evening, daily symptoms score and use of inhaled β2-agonists did not reveal any clinically significant differences between the drugs or between high (800 μg BUD, 1000 μg BDP) and low (400 mg BUD/BDP) doses. However, statistically significant differences were recorded for the corresponding parameters when comparing the placebo with preceding steroid periods. Adverse effects consisting mainly of oropharyngeal candidiasis, hoarseness and cough occurred in 54 of 468 treatment months (12 %). The carry-over effects of inhaled steroids are longer lasting than was previously assumed.