SUBSTITUTION OF INHALED BECLOMETHASONE DIPROPIONATE FOR INGESTED PREDNISONE IN STEROID-DEPENDENT ASTHMATICS

  • 1 January 1977
    • journal article
    • research article
    • Vol. 116  (8) , 867-871
Abstract
The effect of inhaled beclomethasone dipropionate (400 .mu.g daily) was investigated in 31 prednisone-dependent asthmatics. In a double-blind noncrossover study of 25 patients dependent on a daily prednisone dose of 17.5 mg or less, the dose of ingested prednisone was significantly diminished through the use of beclomethasone as compared with placebo. In a subsequent single-blind study of the 12 patients who had recived placebo, a similar decrease in prednisone dose was possible when these patients recived beclomethasone. In all 25 patients the effect of beclomethasone was maintained for 2 yr; 9 came to require less beclomethasone and 1 required more. In n additional single-blind study of 6 patients with severe asthma, dependent on prednisone nn a dose of 20-25 mg/day, the response to beclomethasone was more variable and less significant. At 2 yr there was no significant benefit and there were 2 treatment failures. In patients in whom reduction of dose or discontinuation of prednisone was possible plasma cortisol values before and after corticotropin administration increased significantly. Prednisone reduction was associated with the appearance of mild musculoskeletal steroid-withdrawal symptoms of short duration in 15 patients, and recurrence of symptoms of rhinitis in 15 patients. Side-effects of beclomethasone included episodes of hoarseness in 6 and easily treated oropharyngeal Candida albicans infection in 14.