Equivalent asthma control after dose reduction with HFA-134a beclomethasone solution aerosol

Aim: The replacement of chlorofluorocarbon (CFC) by hydrofluoroalkane has the potential to improve airway deposition of BDP. We investigated whether HFA-BDP extra-fine solution aerosol 400 mu g day(-1) is as effective as CFC-BDP 1000 mu g day(-1) in patients with stable, moderate asthma, having persistent bronchial hyperresponsiveness. Patients and Methods: One hundred and fifty patients with moderate asthma from 20 centres, on inhaled steroids for less than or equal to 3 months, entered a 4-week run-in period with 1000 mu g day(-1) CFC-BDP. Patients were then allocated to a 10-week study phase, receiving CFC-BDP 1000 mu g day(-1) or HFA-BDP 400 mu g day(-1). Symptom score and PEF were measured daily and recorded as biweekly means. Spirometry, PC20FEV1, blood eosinophils and serum ECP were determined on days 15, 29, 43 and 71, and compared to the last visit of the run-in period. All group members were trained in a quality control centre. Results: Treating the population of the HFA-BDP group (n = 72) and the CFC-BDP group (n = 78) did not show significant differences in terms of symptoms, lung function, airway hyperresponsiveness and serum markers of inflammation at the end of the run-in period and the end of the study phase. Conclusion: Using HFA instead of a CFC metered dose inhaler, containing less than half the daily dose of BDP, allows control of symptoms and lung function parameters, without changes in bronchial hyperresponsiveness.