Therapeutic ratio of hydrofluroalkane and chlorofluorocarbon formulations of fluticasone propionate

Fowler, Stephen J., Orr, Linda C., Sims, Erika J. ORCID: https://orcid.org/0000-0002-7898-0331, Wilson, Andrew M., Currie, Graeme P., McFarlane, Lesley and Lipworth, Brian J. (2002) Therapeutic ratio of hydrofluroalkane and chlorofluorocarbon formulations of fluticasone propionate. Chest, 122 (2). pp. 618-623. ISSN 1931-3543

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Abstract

Objectives: To compare the therapeutic ratio of chlorofluorocarbon (CFC) and hydrofluoroalkane-134a (HFA) formulations of fluticasone propionate (FP). Methods: We performed a randomized, placebo-controlled, crossover study comparing 6 weeks of treatment with FP using 500 μg/d and 1,000 μg/d formulations of CFC and HFA. The primary end points were provocative dose of methacholine causing a 20% fall in FEV1 (PD20) and overnight urinary cortisol/creatinine excretion. Results: Eighteen patients with mild-to-moderate asthma and geometric mean (SEM) PD20 of 82.3 μg (19.2 μg) completed the study. All treatments significantly improved PD20 values and morning peak expiratory flow vs placebo, while 1,000 μg/d was significantly better than 500 μg/d for the CFC formulation of FP (CFC-FP) but not the HFA formulation of FP (HFA-FP). Only 1,000 μg/d of CFC-FP caused significant suppression of overnight urinary cortisol/creatinine compared to placebo. There were no differences between formulations at either dose. Conclusions: The increased airway benefit with CFC-FP > 500 μg/d was offset by greater systemic effects. Although HFA-FP had fewer systemic effects than CFC-FP at 1,000 μg/d, there was no benefit to increasing HFA-FP to > 500 μg/d.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User:	EPrints Services
Date Deposited:	25 Nov 2010 11:13
Last Modified:	17 Jun 2024 12:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/15011
DOI:	10.1378/chest.122.2.618

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