Systematic review of the dose-response relation of inhaled fluticasone propionate

Archives of Disease in Childhood
M MasoliR Beasley

Abstract

To examine the dose-response relation of inhaled fluticasone for both efficacy and adrenal function in children with asthma. Systematic review of double blind randomised dose-response studies of fluticasone in children of at least 4 weeks duration. FEV1, morning peak expiratory flow, night awakenings, beta agonist use, major exacerbations, 12 or 24 hour urinary cortisol, peak plasma cortisol post-stimulation. Seven studies of 1733 children with asthma met the inclusion criteria for efficacy. The dose-response curve for each efficacy outcome measure suggested that the response began to plateau between 100 and 200 microg per day with additional efficacy at the 400 microg per day dose shown in one study of severe asthmatics. Five studies of 1096 children with asthma met the inclusion criteria for assessment of adrenal function. The largest placebo controlled study of 437 children reported no difference in 24 hour urinary cortisol between placebo and fluticasone at doses of 100 and 200 microg per day. The non-placebo controlled study of 528 children reported significant suppression of overnight urinary cortisol levels with fluticasone at 400 compared with 200 microg per day. There is insufficient data to determine the dose-response...Continue Reading

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Citations

Feb 11, 2004·Current Allergy and Asthma Reports·Matthew MasoliRichard Beasley
Oct 11, 2005·Journal of Feline Medicine and Surgery·Nathalie KirschvinkPascal Gustin
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