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Comparison of the efficacy of ciclesonide with that of budesonide in mild to moderate asthma patients after step-down therapy: a randomised parallel-group study.

Chiu KC, Chou YL, Hsu JY, Lin MS, Lin CH, Chou PC, Chou CL, Wang CH, Kuo HP - NPJ Prim Care Respir Med (2014)

Bottom Line: This study aimed to compare the clinical benefit of CIC with budesonide (BUD) in step-down therapy.Drug adherence was significantly higher in the CIC group than in the BUD group (76.0% vs. 58.7%, P=0.03).Both patients and physicians ranked CIC over BUD.

View Article: PubMed Central - PubMed

Affiliation: Division of Chest, Department of Internal Medicine, Poh-Ai Hospital, Luodong, Taiwan.

ABSTRACT

Background: Inhaled corticosteroids (ICSs) are widely used in asthma control. Ciclesonide (CIC) is an ICS with on-site lung activation for potent anti-inflammatory activity.

Aims: This study aimed to compare the clinical benefit of CIC with budesonide (BUD) in step-down therapy.

Methods: A total of 150 patients with mild-to-moderate asthma well controlled by a combination of ICS and long-acting β2-agonist were randomised to receive either CIC 320 μg (n=75) once daily or 2 inhalations of BUD 200 μg (n=75) twice daily for 12 weeks. The forced expiratory volume in 1s (FEV1), maximum mid-expiratory flow (MMEF) and asthma control test (ACT) scores were measured. Ranked stratification of patients and physicians was assessed.

Results: Drug adherence was significantly higher in the CIC group than in the BUD group (76.0% vs. 58.7%, P=0.03). The FEV1 and MMEF remained stable throughout the 12-week CIC treatment. In the BUD group, FEV1 significantly decreased at weeks 4 and 12. MMEF had a higher value in the CIC group than in the BUD group. Both patients and physicians ranked CIC over BUD.

Conclusions: CIC is more effective and has better drug adherence than BUD as step-down treatment when asthma is well controlled by combination therapy.

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Related in: MedlinePlus

(a) Flowchart of patient disposition. Withdrawal due to poor control of asthma involved 64.5% of patients in the budesonide group but only 22.2% of patients in the ciclesonide group. (b) Percentage of patient adherence to the study after 4, 8 and 12 weeks of treatment in the ciclesonide and budesonide groups. The percentage of adherence to the study was significantly decreased in the budesonide group compared with the ciclesonide group until the end of the study. The P value was calculated by means of the log-rank (Mantel–Cox) test.
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fig2: (a) Flowchart of patient disposition. Withdrawal due to poor control of asthma involved 64.5% of patients in the budesonide group but only 22.2% of patients in the ciclesonide group. (b) Percentage of patient adherence to the study after 4, 8 and 12 weeks of treatment in the ciclesonide and budesonide groups. The percentage of adherence to the study was significantly decreased in the budesonide group compared with the ciclesonide group until the end of the study. The P value was calculated by means of the log-rank (Mantel–Cox) test.

Mentions: Of the 162 patients with asthma who were approached, 8 refused and 4 failed the initial screening during enrolment (Figure 2a). Figure 2 gives an overview of the patient disposition. Four (22.2%) in the CIC group and 19 (65.0%) in the BUD group (P=0.007) did not complete the treatment because of poor control of asthma (Figure 2a), manifesting as daytime symptoms more than twice a week, nocturnal attacks or waking, need for rescue medicine more than twice a week, or limitation of daily activities because of asthmatic symptoms.


Comparison of the efficacy of ciclesonide with that of budesonide in mild to moderate asthma patients after step-down therapy: a randomised parallel-group study.

Chiu KC, Chou YL, Hsu JY, Lin MS, Lin CH, Chou PC, Chou CL, Wang CH, Kuo HP - NPJ Prim Care Respir Med (2014)

(a) Flowchart of patient disposition. Withdrawal due to poor control of asthma involved 64.5% of patients in the budesonide group but only 22.2% of patients in the ciclesonide group. (b) Percentage of patient adherence to the study after 4, 8 and 12 weeks of treatment in the ciclesonide and budesonide groups. The percentage of adherence to the study was significantly decreased in the budesonide group compared with the ciclesonide group until the end of the study. The P value was calculated by means of the log-rank (Mantel–Cox) test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4373304&req=5

fig2: (a) Flowchart of patient disposition. Withdrawal due to poor control of asthma involved 64.5% of patients in the budesonide group but only 22.2% of patients in the ciclesonide group. (b) Percentage of patient adherence to the study after 4, 8 and 12 weeks of treatment in the ciclesonide and budesonide groups. The percentage of adherence to the study was significantly decreased in the budesonide group compared with the ciclesonide group until the end of the study. The P value was calculated by means of the log-rank (Mantel–Cox) test.
Mentions: Of the 162 patients with asthma who were approached, 8 refused and 4 failed the initial screening during enrolment (Figure 2a). Figure 2 gives an overview of the patient disposition. Four (22.2%) in the CIC group and 19 (65.0%) in the BUD group (P=0.007) did not complete the treatment because of poor control of asthma (Figure 2a), manifesting as daytime symptoms more than twice a week, nocturnal attacks or waking, need for rescue medicine more than twice a week, or limitation of daily activities because of asthmatic symptoms.

Bottom Line: This study aimed to compare the clinical benefit of CIC with budesonide (BUD) in step-down therapy.Drug adherence was significantly higher in the CIC group than in the BUD group (76.0% vs. 58.7%, P=0.03).Both patients and physicians ranked CIC over BUD.

View Article: PubMed Central - PubMed

Affiliation: Division of Chest, Department of Internal Medicine, Poh-Ai Hospital, Luodong, Taiwan.

ABSTRACT

Background: Inhaled corticosteroids (ICSs) are widely used in asthma control. Ciclesonide (CIC) is an ICS with on-site lung activation for potent anti-inflammatory activity.

Aims: This study aimed to compare the clinical benefit of CIC with budesonide (BUD) in step-down therapy.

Methods: A total of 150 patients with mild-to-moderate asthma well controlled by a combination of ICS and long-acting β2-agonist were randomised to receive either CIC 320 μg (n=75) once daily or 2 inhalations of BUD 200 μg (n=75) twice daily for 12 weeks. The forced expiratory volume in 1s (FEV1), maximum mid-expiratory flow (MMEF) and asthma control test (ACT) scores were measured. Ranked stratification of patients and physicians was assessed.

Results: Drug adherence was significantly higher in the CIC group than in the BUD group (76.0% vs. 58.7%, P=0.03). The FEV1 and MMEF remained stable throughout the 12-week CIC treatment. In the BUD group, FEV1 significantly decreased at weeks 4 and 12. MMEF had a higher value in the CIC group than in the BUD group. Both patients and physicians ranked CIC over BUD.

Conclusions: CIC is more effective and has better drug adherence than BUD as step-down treatment when asthma is well controlled by combination therapy.

Show MeSH
Related in: MedlinePlus