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Meta-Analysis
. 2005 Jan 25;2005(1):CD002738.
doi: 10.1002/14651858.CD002738.pub2.

Inhaled beclomethasone versus placebo for chronic asthma

N P Adams, J B Bestall, R Malouf, T J Lasserson, P W Jones
Meta-Analysis

Inhaled beclomethasone versus placebo for chronic asthma

N P Adams et al. Cochrane Database Syst Rev. .

Abstract

Background: Inhaled beclomethasone dipropionate (BDP) has been, together with inhaled budesonide, the mainstay of anti-inflammatory therapy for asthma for many years. A range of new prophylactic therapies for asthma is becoming available and BDP has been reformulated using a hydrofluoroalkane-134a (HFA) propellant which is free from chlorofluorocarbon (CFC).

Objectives: The objectives of this review were to: (1) Compare the efficacy of BDP with placebo with both CFC and HFA propellants in the treatment of chronic asthma. (2) Explore the possibility that a dose response relationship exists for BDP in the treatment of chronic asthma. (3) To provide the best estimate of the efficacy of BDP as a benchmark for evaluation of newer asthma therapies.

Search strategy: Electronic searches were current as of January 2003.

Selection criteria: Randomised parallel group design trials for a minimum period of four weeks, in children and adults comparing CFC-BDP or HFA-BDP with placebo in the treatment of chronic asthma. Two reviewers independently assessed articles for inclusion and methodological quality.

Data collection and analysis: One reviewer extracted data; authors were contacted to clarify missing information. We analysed data with RevMan Analyses 1.0.2.

Main results: 60 studies recruiting 6542 participants met the inclusion criteria. CFC-BDP (57 studies): In non-oral steroid treated patients, at doses of 400 mcg/day or less CFC-BDP produced significant improvements from baseline in a number of efficacy measures compared with placebo, including forced expiratory volume in one second (FEV1) 360 ml (95% CI 260 to 460); FEV1 (% predicted) WMD 12.41% (95% CI 8.18 to 16.64) and morning peak expiratory flow rate (am PEF) WMD 35.95 L/min (95% CI 27.85 to 44.04). BDP also led to reductions in rescue beta-2 agonist use compared with placebo of -2.32 puffs/d (95% CI -2.55 to -2.09) and reduced the relative risk (RR) of trial withdrawal due to an asthma exacerbation 0.25 (95% CI 0.12 to 0.51). Subgroup analyses based on treatment duration provide support to the proposal that a treatment period of greater than four weeks is required to realise a fuller treatment effect. In oral steroid treated patients BDP led to significantly greater reductions in oral prednisolone use WMD -4.91 mg/d (95% CI -5.88 to -3.94 mg/d) and greater likelihood of withdrawing oral steroid treatment RR 8.02 (95% CI 3.23 to 19.92). HFA-BDP (3 studies): In non-oral steroid-treated patients, HFA-BDP was significantly more effective than placebo in improving FEV1, morning and evening PEF, FEF25 to 75%, reduced asthma symptoms and beta2-agonists daily consumption. Significant effects for such outcomes were apparent after six weeks of treatment. In oral steroid treated patients, HFA-BDP improved significantly FEV1 and am PEF. The summary estimates for these outcomes suggested a high level of heterogeneity, and divergent aims of the studies may contribute to the variation we observed. Limited data on adverse events were reported.

Authors' conclusions: This review has quantified the efficacy of CFC-BDP and HFA-BDP in the treatment of chronic asthma and strongly supports its use. Current asthma guidelines recommend titration of dose to individual patient response, but the published data provide little support for dose titration above 400 mcg/d in patients with mild to moderate asthma. There are insufficient data to draw any conclusions concerning dose-response in people with severe asthma.

PubMed Disclaimer

Conflict of interest statement

None

Figures

1.1
1.1. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 1 FEV1 (L) and FEV1 (% predicted) combined.
1.2
1.2. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 2 Change in FEV1(L/min).
1.3
1.3. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 3 Change in FEV1 (%).
1.4
1.4. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 4 FVC (L).
1.5
1.5. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 5 Change in FVC (L).
1.6
1.6. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 6 Change in morning PEF (L/min).
1.7
1.7. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 7 Morning PEF (L/min).
1.8
1.8. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 8 Change in evening PEF (L/min).
1.9
1.9. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 9 FEF 25 to 75 (L/second).
1.10
1.10. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 10 Change in FEF 25‐75% (L/second).
1.11
1.11. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 11 Weekly asthma symptom score.
1.12
1.12. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 12 Methacholine bronchial responsiveness (log10 PC20 FEV1).
1.13
1.13. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 13 Daily use of beta‐2 agonist (puffs/day).
1.14
1.14. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 14 Change in daily use of beta‐2 agonist (puffs/day).
1.15
1.15. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 15 Nights without sleep disturbance due to asthma symptoms (%).
1.16
1.16. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 16 Change in nocturnal awakenings (nights/wk).
1.17
1.17. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 17 Change in daily asthma symptoms score.
1.18
1.18. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 18 Change in cough score.
1.19
1.19. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 19 Change in wheezing score.
1.20
1.20. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 20 Change in breathing difficulty score.
1.21
1.21. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 21 Change in eosinophil count (cells x 103/micL).
1.22
1.22. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 22 Total withdrawals.
1.23
1.23. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 23 Withdrawals due to adverse effects.
1.24
1.24. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 24 Withdrawals due to asthma exacerbations.
1.25
1.25. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 25 Numbe of participants with asthma attacks.
1.26
1.26. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 26 Worsening asthma.
1.27
1.27. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 27 Influenza.
1.28
1.28. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 28 Oral candidiasis.
1.29
1.29. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 29 Pharyngitis.
1.30
1.30. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 30 Dysphonia.
1.31
1.31. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 31 Dyspepsia.
1.32
1.32. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 32 Cough.
1.34
1.34. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 34 Fatigue.
1.35
1.35. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 35 Nausea.
1.36
1.36. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 36 Bronchitis.
1.37
1.37. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 37 Sinustis.
1.38
1.38. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 38 Rash.
1.40
1.40. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 40 Oropharyngeal side effects.
1.41
1.41. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 41 Headache.
1.42
1.42. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 42 Upper respiratory tract infection side effects.
1.43
1.43. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 43 Alanine aminotransferase (ALT) > normal upper limit.
1.44
1.44. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 44 Alanine aminotransferase (ALT) > 3 times of upper limit of normal.
1.45
1.45. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 45 Asparate amibotransferase (AST) >upper normal limit.
1.46
1.46. Analysis
Comparison 1 CFC‐BDP versus Placebo, not on oral steroids: 400 mcg/d or less, Outcome 46 Aspartate aminotransferase (AST) > 3 times upper normal limit.
2.1
2.1. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 1 FEV1 (L) and FEV1 (% Predicted) combined.
2.2
2.2. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 2 FVC (L).
2.3
2.3. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 3 FEF 25 to 75% (L/second).
2.4
2.4. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 4 Morning PEFR (L/min).
2.5
2.5. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 5 Change in morning PEF (L/min).
2.6
2.6. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 6 Evening PEFR (L/min).
2.7
2.7. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 7 Daily PEFR (L/min).
2.8
2.8. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 8 Diurnal variation in PEFR (%).
2.9
2.9. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 9 Histamine bronchial responsiveness (log10 PC20 FEV1).
2.10
2.10. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 10 Methacholine bronchial responsiveness (Dmin).
2.11
2.11. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 11 Daily use of beta2 agonists (puffs/day).
2.12
2.12. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 12 Change in daily use of beta‐2 agonists (puffs/day).
2.13
2.13. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 13 Daily asthma symptom score.
2.14
2.14. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 14 Change in daily asthma symptom score.
2.15
2.15. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 15 Nights without disturbance(%).
2.16
2.16. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 16 Withdrawal due to worsening asthma symptoms.
2.17
2.17. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 17 Withdrawal due to asthma exacerbation (No. of patients).
2.18
2.18. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 18 At least one side effect reported.
2.19
2.19. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 19 Number of participants with normal plasma cortisol levels.
2.20
2.20. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 20 Dysphonia.
2.21
2.21. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 21 Cough.
2.22
2.22. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 22 Adverse inhalation feel/pharyngitis.
2.23
2.23. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 23 Adverse inhalation taste.
2.24
2.24. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 24 Laryngitis.
2.25
2.25. Analysis
Comparison 2 CFC‐BDP versus Placebo, not on oral steroids: 500 to 800 mcg/d, Outcome 25 Oropharyngeal side‐effects (No. of patients).
3.1
3.1. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 1 FEV1 (L) and FEV1 (% predicted) combined.
3.2
3.2. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 2 FVC (% predicted).
3.3
3.3. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 3 FEV1/FVC ratio (%).
3.4
3.4. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 4 Change in FEV1 (L).
3.5
3.5. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 5 Clinic PEFR (L/min).
3.6
3.6. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 6 PEF (% predicted).
3.7
3.7. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 7 Daily use of beta‐2 agonists (puffs/day).
3.8
3.8. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 8 Daily asthma symptom score.
3.9
3.9. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 9 Methacholine bronchial responsiveness (log values).
3.10
3.10. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 10 plasma cortisol (mmol/L).
3.11
3.11. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 11 Plasma cortisol (mmol/L) 120 min after 0.1IU/kg body weight insulin.
3.12
3.12. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 12 Serum eosinophil count (x10 6/L).
3.13
3.13. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 13 Serum eosinophil catonic protein (ECP) (mcg/L).
3.14
3.14. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 14 FEV1 (L) following inhaled cold air challenge.
3.15
3.15. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 15 Inspiratory Vital Capacity (L) following inhaled cold air challenge.
3.16
3.16. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 16 Withdrawal due to asthma exacerbation.
3.17
3.17. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 17 Oropharyngeal side‐effects.
3.18
3.18. Analysis
Comparison 3 CFC‐BDP versus Placebo, not on oral steroids: 1000 mcg/d or greater, Outcome 18 Oropharyngeal Candidiasis.
4.1
4.1. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 1 FEV1 (L).
4.2
4.2. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 2 FEV1 (% predicted).
4.3
4.3. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 3 Change in FEV1 (L).
4.5
4.5. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 5 Morning PEFR (L/min).
4.6
4.6. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 6 Change in morning PEF (L/min).
4.7
4.7. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 7 FVC (L).
4.9
4.9. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 9 Methacholine bronchial responsiveness (log 10 values).
4.10
4.10. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 10 FEF25‐75% (L/Second).
4.12
4.12. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 12 Daily asthma symptom score.
4.13
4.13. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 13 Daily asthma symptoms score (change from baseline).
4.14
4.14. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 14 Daily use of beta2 agonists (puffs/day).
4.15
4.15. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 15 Change in rescue beta‐agonist use.
4.16
4.16. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 16 Withdrawal due to asthma exacerbation.
4.17
4.17. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 17 Oral candidiasis.
4.18
4.18. Analysis
Comparison 4 CFC‐BDP versus Placebo, not on oral steroids: all doses, Outcome 18 Oropharyngeal side‐effects.
5.1
5.1. Analysis
Comparison 5 CFC‐BDP versus Placebo, not on oral steroids: all severities, Outcome 1 FEV1 (L).
5.2
5.2. Analysis
Comparison 5 CFC‐BDP versus Placebo, not on oral steroids: all severities, Outcome 2 FEV1(% predicted).
5.4
5.4. Analysis
Comparison 5 CFC‐BDP versus Placebo, not on oral steroids: all severities, Outcome 4 Change in morning PEF (L/min).
5.5
5.5. Analysis
Comparison 5 CFC‐BDP versus Placebo, not on oral steroids: all severities, Outcome 5 Daily use of beta2 agonist (puffs/day).
5.6
5.6. Analysis
Comparison 5 CFC‐BDP versus Placebo, not on oral steroids: all severities, Outcome 6 Daily asthma symptom score.
5.7
5.7. Analysis
Comparison 5 CFC‐BDP versus Placebo, not on oral steroids: all severities, Outcome 7 Methacholine bronchial responsiveness (log values).
5.8
5.8. Analysis
Comparison 5 CFC‐BDP versus Placebo, not on oral steroids: all severities, Outcome 8 Withdrawal due to asthma exacerbation.
5.9
5.9. Analysis
Comparison 5 CFC‐BDP versus Placebo, not on oral steroids: all severities, Outcome 9 Oropharyngeal side‐effects.
6.1
6.1. Analysis
Comparison 6 CFC‐BDP versus Placebo, not oral steroids: all delivery devices, Outcome 1 FEV (L).
6.2
6.2. Analysis
Comparison 6 CFC‐BDP versus Placebo, not oral steroids: all delivery devices, Outcome 2 FEV1 (% predicted).
6.3
6.3. Analysis
Comparison 6 CFC‐BDP versus Placebo, not oral steroids: all delivery devices, Outcome 3 Morning PEFR (L/min).
6.4
6.4. Analysis
Comparison 6 CFC‐BDP versus Placebo, not oral steroids: all delivery devices, Outcome 4 Change in morning PEF (L/min).
6.5
6.5. Analysis
Comparison 6 CFC‐BDP versus Placebo, not oral steroids: all delivery devices, Outcome 5 Daily use of beta2 agonists (puffs/day).
6.6
6.6. Analysis
Comparison 6 CFC‐BDP versus Placebo, not oral steroids: all delivery devices, Outcome 6 Daily asthma symptom score.
6.7
6.7. Analysis
Comparison 6 CFC‐BDP versus Placebo, not oral steroids: all delivery devices, Outcome 7 Methacholine bronchial responsiveness (log values).
6.11
6.11. Analysis
Comparison 6 CFC‐BDP versus Placebo, not oral steroids: all delivery devices, Outcome 11 Withdrawal due to asthma exacerbation.
6.12
6.12. Analysis
Comparison 6 CFC‐BDP versus Placebo, not oral steroids: all delivery devices, Outcome 12 Oropharyngeal side‐effects.
7.1
7.1. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 1 FEV1 (L).
7.2
7.2. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 2 FEV1 (% predicted).
7.3
7.3. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 3 FEV1 % (change from baseline).
7.4
7.4. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 4 Morning PEFR (L/min).
7.5
7.5. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 5 Change in morning PEF (L/min).
7.6
7.6. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 6 Methacholine bronchial responsiveness (log values).
7.7
7.7. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 7 FEF25‐75% (L/second).
7.10
7.10. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 10 Total daily Beta2‐agonist use (change from baseline).
7.11
7.11. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 11 Daily use of Beta2‐ agonists (puffs per day).
7.12
7.12. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 12 Daytime asthma symptoms score (change from baseline).
7.13
7.13. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 13 Daily asthma symptoms score.
7.40
7.40. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 40 Withdrawals due to asthma exacerbation.
7.41
7.41. Analysis
Comparison 7 CFC‐BDP versus placebo, not on oral steroids: all study durations, Outcome 41 Oropharyngel side‐effect.
8.1
8.1. Analysis
Comparison 8 CFC‐BDP versus Placebo,on oral steroids: 400 mcg/d or less, Outcome 1 FEV1 (% predicted).
8.2
8.2. Analysis
Comparison 8 CFC‐BDP versus Placebo,on oral steroids: 400 mcg/d or less, Outcome 2 Daily dose of oral prednisiolone (mg).
8.3
8.3. Analysis
Comparison 8 CFC‐BDP versus Placebo,on oral steroids: 400 mcg/d or less, Outcome 3 Reduction in daily dose of oral prednisolone (mg).
8.4
8.4. Analysis
Comparison 8 CFC‐BDP versus Placebo,on oral steroids: 400 mcg/d or less, Outcome 4 Daytime asthma symptom score.
8.5
8.5. Analysis
Comparison 8 CFC‐BDP versus Placebo,on oral steroids: 400 mcg/d or less, Outcome 5 Night‐time asthma symptom score.
8.6
8.6. Analysis
Comparison 8 CFC‐BDP versus Placebo,on oral steroids: 400 mcg/d or less, Outcome 6 Plasma cortisol (mmol/L).
8.7
8.7. Analysis
Comparison 8 CFC‐BDP versus Placebo,on oral steroids: 400 mcg/d or less, Outcome 7 Oropharyngeal side‐effects.
8.8
8.8. Analysis
Comparison 8 CFC‐BDP versus Placebo,on oral steroids: 400 mcg/d or less, Outcome 8 Oropharyngeal Candidiasis (No. of patients).
8.9
8.9. Analysis
Comparison 8 CFC‐BDP versus Placebo,on oral steroids: 400 mcg/d or less, Outcome 9 Discontinuation of oral steroids (No. of patients).
9.7
9.7. Analysis
Comparison 9 CFC‐BDP versus Placebo, on oral steroids: 500‐800 mcg/d, Outcome 7 Discontinuation of oral steroids.
9.8
9.8. Analysis
Comparison 9 CFC‐BDP versus Placebo, on oral steroids: 500‐800 mcg/d, Outcome 8 Oropharyngeal candidiasis.
9.9
9.9. Analysis
Comparison 9 CFC‐BDP versus Placebo, on oral steroids: 500‐800 mcg/d, Outcome 9 Oropharyngeal side‐effects.
10.1
10.1. Analysis
Comparison 10 CFC‐BDP versus Placebo, on oral steroids: 1000 mcg/d or greater, Outcome 1 Change in FEV1(%).
10.2
10.2. Analysis
Comparison 10 CFC‐BDP versus Placebo, on oral steroids: 1000 mcg/d or greater, Outcome 2 PEF (% predicted).
10.3
10.3. Analysis
Comparison 10 CFC‐BDP versus Placebo, on oral steroids: 1000 mcg/d or greater, Outcome 3 Daily asthma symptom score.
10.4
10.4. Analysis
Comparison 10 CFC‐BDP versus Placebo, on oral steroids: 1000 mcg/d or greater, Outcome 4 Daily dose of oral prednislone (mg).
10.5
10.5. Analysis
Comparison 10 CFC‐BDP versus Placebo, on oral steroids: 1000 mcg/d or greater, Outcome 5 Discontinuation of oral prednisolone.
11.1
11.1. Analysis
Comparison 11 CFC‐BDP versus Placebo, on oral steroids: all doses, Outcome 1 Reduction in daily dose of oral prednisolone (mg).
11.2
11.2. Analysis
Comparison 11 CFC‐BDP versus Placebo, on oral steroids: all doses, Outcome 2 Daily dose of oral prednisolone (mg).
11.3
11.3. Analysis
Comparison 11 CFC‐BDP versus Placebo, on oral steroids: all doses, Outcome 3 Discontinuation of oral steroids (No. of patients).
12.1
12.1. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 1 FEV1(% predicted change from baseline).
12.2
12.2. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 2 Change in morning PEF (L/min).
12.3
12.3. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 3 Change in evening PEF (L/min).
12.4
12.4. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 4 FEF25%‐75% (%change from baseline).
12.5
12.5. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 5 FEV1 (L/min).
12.6
12.6. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 6 Change in beta2‐agonist use (puffs/day).
12.7
12.7. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 7 Asthma symptoms score: wheeze (change from baseline).
12.8
12.8. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 8 Asthma symptoms score: cough (change from baseline).
12.9
12.9. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 9 Asthma symptoms score: shortness of breath (Change from baseline).
12.10
12.10. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 10 Asthma symptoms scores: Chest tightness (change from baseline).
12.11
12.11. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 11 Days free from any asthma symptoms (%).
12.12
12.12. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 12 Nights without sleep disturbance %.
12.13
12.13. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 13 Change in percentage of nights without sleep disturbance.
12.14
12.14. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 14 Exacerbations of asthma.
12.15
12.15. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 15 Increased asthma symptoms.
12.16
12.16. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 16 Total withdrawals.
12.17
12.17. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 17 Withdrawals due to adverse events.
12.18
12.18. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 18 Withdrawals due to non‐compliance.
12.19
12.19. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 19 >/= one side‐effect reported.
12.20
12.20. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 20 Cough.
12.21
12.21. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 21 Pharyngitis.
12.22
12.22. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 22 Rhinitis.
12.23
12.23. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 23 Sinusitis.
12.24
12.24. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 24 Upper respiratory tract infection.
12.25
12.25. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 25 Low morning plasma cortisol levels.
12.26
12.26. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 26 Abnormal respones to low dose ACTH stimulation.
12.28
12.28. Analysis
Comparison 12 HFA‐BDP versus Placebo, not on oral sterids: 400 mcg/d or less ‐ Hampel and Nayak 100mcg arms, Outcome 28 Change in beta2‐agonist use (puffs/day, predosing schedule subgroup analysis).
13.1
13.1. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 1 FEV1 (% predicted) (change from baseline).
13.2
13.2. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 2 Change in morning PEF (L/min).
13.3
13.3. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 3 Change in evening PEF (L/min).
13.4
13.4. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 4 Change in FEF25‐75 (%).
13.5
13.5. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 5 Change in beta2‐agonist use (puffs/day).
13.6
13.6. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 6 Nights without sleep disturbance (%).
13.7
13.7. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 7 Change in percentage of nights without sleep disturbance.
13.8
13.8. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 8 Asthma symptoms score: cough (change from baseline).
13.9
13.9. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 9 Asthma symptoms score: shortness of breath (change from baseline).
13.10
13.10. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 10 Asthma symptoms score: chest tightness (change from baseline).
13.11
13.11. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 11 Asthma symptoms score: wheeze (change from baseline).
13.12
13.12. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 12 Days free from any asthma symptoms (%).
13.13
13.13. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 13 Exacerbations of asthma.
13.14
13.14. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 14 Increased asthma symptoms.
13.15
13.15. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 15 Total withdrawals.
13.16
13.16. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 16 Withdrawals due to inadequate response.
13.17
13.17. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 17 Withdrawals due to adverse events.
13.18
13.18. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 18 >/= one side‐effect reported.
13.19
13.19. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 19 Sinusitis.
13.20
13.20. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 20 Upper respiratory tract infection.
13.21
13.21. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 21 Low morning plasma cortisol levels.
13.22
13.22. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 22 Abnormal respones to low dose ACTH stimulation.
13.23
13.23. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 23 Cough.
13.24
13.24. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 24 Pharyngitis.
13.25
13.25. Analysis
Comparison 13 HFA‐BDP versus Placebo, not on oral steroids: 400mcg/d or less ‐ Hampel and Nayak 160 to 200 mcg arms, Outcome 25 Rhinitis.
14.1
14.1. Analysis
Comparison 14 BDP versus Placebo: Crossover studies, not on oral steroids: 400 mcg/d or less, Outcome 1 FEV1 (L).
14.2
14.2. Analysis
Comparison 14 BDP versus Placebo: Crossover studies, not on oral steroids: 400 mcg/d or less, Outcome 2 FVC (L).
14.3
14.3. Analysis
Comparison 14 BDP versus Placebo: Crossover studies, not on oral steroids: 400 mcg/d or less, Outcome 3 Daily PEFR (L/min).
14.4
14.4. Analysis
Comparison 14 BDP versus Placebo: Crossover studies, not on oral steroids: 400 mcg/d or less, Outcome 4 Daily asthma symptom score.
14.5
14.5. Analysis
Comparison 14 BDP versus Placebo: Crossover studies, not on oral steroids: 400 mcg/d or less, Outcome 5 Methacholine bronchial responsiveness (log10 PD20 FEV1).
14.6
14.6. Analysis
Comparison 14 BDP versus Placebo: Crossover studies, not on oral steroids: 400 mcg/d or less, Outcome 6 Histamine bronchial responsiveness (log10 PC20 FEV1).
14.7
14.7. Analysis
Comparison 14 BDP versus Placebo: Crossover studies, not on oral steroids: 400 mcg/d or less, Outcome 7 8am serum cortisol (mmol/L).
14.8
14.8. Analysis
Comparison 14 BDP versus Placebo: Crossover studies, not on oral steroids: 400 mcg/d or less, Outcome 8 4pm serum cortisol (mmol/L).
14.9
14.9. Analysis
Comparison 14 BDP versus Placebo: Crossover studies, not on oral steroids: 400 mcg/d or less, Outcome 9 Serum cortisol 30 mins post 0.25mg cosyntropin (mmol/L).
15.1
15.1. Analysis
Comparison 15 BDP versus Placebo: Crossover studies, not on oral steroids: 1000 mcg/d or greater, Outcome 1 FEV1 (L).
15.2
15.2. Analysis
Comparison 15 BDP versus Placebo: Crossover studies, not on oral steroids: 1000 mcg/d or greater, Outcome 2 Methacholine bronchial responsivness (log10 PD20 FEV1).
16.1
16.1. Analysis
Comparison 16 BDP versus Placebo: Crossover studies, on oral steroids, 400 mcg/d or less, Outcome 1 Patient preference for BDP rather than placebo.
16.2
16.2. Analysis
Comparison 16 BDP versus Placebo: Crossover studies, on oral steroids, 400 mcg/d or less, Outcome 2 Physician preference for BDP rather than placebo.
17.1
17.1. Analysis
Comparison 17 BDP versus Placebo: Crossover studies, not on oral steroids: all doses, Outcome 1 FEV1 (L).
18.1
18.1. Analysis
Comparison 18 BDP versus Placebo: Crossover studies, not on oral steroids: all severities, Outcome 1 FEV1 (L).
19.1
19.1. Analysis
Comparison 19 BDP versus Placebo: Crossover studies, not on oral steroids: all delivery devices, Outcome 1 FEV1 (L).
20.1
20.1. Analysis
Comparison 20 BDP versus Placebo: Crossover studies, not on oral steroids: all study durations, Outcome 1 FEV1 (L).
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Bel 1990 {published data only}
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Boner 1991 {published data only}
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Brompton/MRC 1974 {published data only}
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Cameron 1973 {published data only}
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Carpentiere 1990 {published data only}
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Chan 1993 {published and unpublished data}
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Davies 1977 {published data only}
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Fournier 1990 {published data only}
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Gaddie 1973 {published data only}
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Gross 1999 {published data only}
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Hampel 2000 {published data only}
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Harvey 1976 {published data only}
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Hodson 1974 {published data only}
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Holst 1974 {published data only}
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Hoshino 1998 {published data only}
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Katsunuma 1993 {published data only}
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Kerigan 1977 {published data only}
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Kerrebijn 1976 {published data only}
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Kraemer 1987 {published data only}
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Lacronique 1991 {published data only}
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Laviolette 1994 {published and unpublished data}
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Laviolette 1999 {published data only}
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Lovera 1975 {published data only}
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Maestrelli 1993 {published data only}
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    1. Malmstrom K, Rodriguez‐Gomez G, Guerra J, Villaran C, Pineiro A, Wei L, Seidenberg B, Reiss. Oral montelukast inhaled beclomethasone and placebo for chronic asthma. Annals of Internal Medicine 1999;130(6):487‐95. - PubMed
Martin 1974 {published data only}
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Matthys 1998 {published data only}
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Messerli 1975 {published data only}
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Radha 1975 {published data only}
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Riordan 1974 {published data only}
    1. Riordan JF, Dash CH, Sillett RW, McNicol MW. A comparison of betamethasone valerate, beclomethasone dipropionate and placebo by inhalation for the treatment of chronic asthma. Postgraduate Medical Journal 1974;50(suppl 4):61‐4. - PubMed
Ryan 1985 {published data only}
    1. Ryan G, Latimer KM, Juniper EF, Roberts RS, Hargreave FE. Effect of beclomethasone dipropionate on bronchial responsiveness to histamine in controlled nonsteroid‐dependent asthma. Journal of Allergy & Clinical Immunology 1985;75(1 Pt 1):25‐30. - PubMed
Salmeron 1989 {published data only}
    1. Salmeron S, Guerin JC, Godard P, et al. High doses of inhaled corticosteroids in unstable chronic asthma. A multicenter, double‐blind, placebo‐controlled study. American Review of Respiratory Disease 1989;140(1):167‐71. - PubMed
Simons 1997 {published data only}
    1. Simons FE. A comparison of beclomethasone, salmeterol, and placebo in children with asthma. Canadian Beclomethasone Dipropionate‐Salmeterol Xinafoate Study Group. New England Journal of Medicine 1997;337:1659‐65. - PubMed
Smith 1973a {published data only}
    1. Smith AP, Booth M, Davey AJ. A controlled trial of beclomethasone dipropionate for asthma. British Journal of Diseases of the Chest 1973;67(3):208‐14. - PubMed
Smith 1973b {published data only}
    1. Smith JM. A clinical trial of beclomethasone dipropionate aerosol in children and adolescents with asthma. Clinical Allergy 1973;3(3):249‐53. - PubMed
Toogood 1977 {published data only}
    1. Toogood JH, Lefcoe NM, Haines DS, et al. A graded dose assessment of the efficacy of beclomethasone dipropionate aerosol for severe chronic asthma. Journal of Allergy & Clinical Immunology 1977;59(4):298‐308. - PubMed
Trigg 1994 {published data only}
    1. Trigg CJ, Manolitsas ND, Wang J, et al. Placebo‐controlled immunopathologic study of four months of inhaled corticosteroids in asthma. American Journal of Respiratory & Critical Care Medicine 1994;150(1):17‐22. - PubMed
Turner 1998 {published data only}
    1. Turner MO, Johnston PR, Pizzichini E, Pizzichini MM, Hussack PA, Hargreave FE. Anti‐inflammatory effects of salmeterol compared with beclomethasone in eosinophilic mild exacerbations of asthma: A randomized, placebo controlled trial. Canadian Respiratory Journal 1998;5(4):261‐8. - PubMed
Vatrella 1996 {published data only}
    1. Ponticiello A, Vatrella A, Parrella R, et al. Inhaled beclomethasone dipropionate (BDP) prevents seasonal changes in atopic asthmatics. Monaldi Archives for Chest Disease 1997;52(2):112‐7. - PubMed
    1. Vatrella A, Ponticiello A, Parrella R, et al. Serum eosinophil cationic protein (ECP) as a marker of disease activity and treatment efficacy in seasonal asthma. Allergy 1996;51(8):547‐55. - PubMed
Vilsvik 1974 {published data only}
    1. Vilsvik JS, Schaanning J. Beclomethasone dipropionate aerosol in adult steroid‐dependent obstructive lung disease. Scandinavian Journal of Respiratory Diseases 1974;55(3):169‐75. - PubMed
Vogt 1976 {published data only}
    1. Vogt F, Chervinsky P, Dwek J, Grieco M. Beclomethasone dipropionate aerosol in the treatment of chronic bronchial asthma. Journal of Allergy & Clinical Immunology 1976;58(2):316‐21. - PubMed
Wang 1994 {published data only}
    1. Wang JH, Trigg CJ, Devalia JL, Jordan S, Davies RJ. Effect of inhaled beclomethasone dipropionate on expression of proinflammatory cytokines and activated eosinophils in the bronchial epithelium of patients with mild asthma. Journal of Allergy & Clinical Immunology 1994;94(6 Pt 1):1025‐34. - PubMed
Webb 1977 {published data only}
    1. Webb DR. Beclomethasone in steroid‐dependent asthma. Effective therapy and recovery of hypothalamo‐pituitary‐adrenal function. The Journal of the American Medical Association 1977;238(14):1508‐11. - PubMed
Wiebicke 1990 {published data only}
    1. Wiebicke W, Jorres R, Magnussen H. Comparison of the effects of inhaled corticosteroids on the airway response to histamine, methacholine, hyperventilation, and sulfur dioxide in subjects with asthma. Journal of Allergy & Clinical Immunology 1990;86(6 Pt 1):915‐23. - PubMed

References to studies excluded from this review

Apold 1975 {published data only}
    1. Apold J. [Treatment of asthma in children with beclomethasone dipropionate aerosols]. Tidsskrift for Den Norske Laegeforening 1975;95(19‐21):1149‐52. - PubMed
Baba 2002 {published data only}
    1. Baba K, Sakakibara A, Tagi T, Niwa S, Wakayama H, Takagi K.
    1. Baba K, Sakakibara A, Tagi T, Niwa S, Wakayama H, Takagi K. Long term observation of the clinical course after step down of corticosteroid inhalation in adult chronic asthmatics correlation with serum levels of eosinophil cationic protein. Respirology 2002;7:225‐66. - PubMed
Bentley 1996 {published data only}
    1. Bentley AM, Walker S, Hanotte F, Vos C, Durham SR. A comparison of the effects of oral cetirizine and inhaled beclomethasone on early and late asthmatic responses to allergen and the associated increase in airways hyperresponsiveness. Clinical & Experimental Allergy 1996;26(8):909‐17. - PubMed
Bonnaud 1991 {published data only}
    1. Bonnaud F, Desfougeres JL. [Treatment of asthma in the adult using a combination of salbutamol 100 micrograms‐‐beclomethasone 50 micrograms. Results of a study on 1917 patients seen in general medicine]. Allergie et Immunologie 1991;23(7):295‐300. - PubMed
Burge 1982 {published data only}
    1. Burge PS. The effects of corticosteroids on the immediate asthmatic reaction. European Journal of Respiratory Diseases ‐ Supplement 1982;122:163‐6. - PubMed
Chang 1998 {published data only}
    1. Chang AB, Phelan PD, Carlin JB, Sawyer SM, Robertson CF. A randomised, placebo controlled trial of inhaled salbutamol and beclomethasone for recurrent cough. Archives of Disease in Childhood 1998;79(1):6‐11. - PMC - PubMed
Choovoravech 1977 {published data only}
    1. Choovoravech P, Choovoravech N, Yongpanich Y, Preeyasombut C. [Beclomethasone dipropionate aerosol in the treatment of chronic bronchial asthma: A preliminary study in Thai subjects]. Journal of the Medical Association of Thailand 1977;60(12):619‐25. - PubMed
Cockcroft {published data only}
    1. Cockcroft DW, McParland CP, O'Byrne PM, et al. Beclomethasone given after the early asthmatic response inhibits the late response and the increased methacholine responsiveness and cromolyn does not. Journal of Allergy and Clinical Immunology 1993;91(6):1163‐8. - PubMed
Del Bufalo 1989 {published data only}
    1. Bufalo C, Impullitti S, Miniero R, Gunella G. [Clinical controlled study on high doses of beclomethasone dipropionate associated with salbutamol in long term treatment of asthmatic subjects]. Rivista di Patologia e Clinica della Tubercolosi e di Pneumologia 1989;60:137‐55.
Douay 1976 {published data only}
    1. Douay B, Robin H, Racadot A. Study of a novel corticoid (Becotide) in chronic asthma and COPD [Étude d'un nouveau corticoïde local, la Bécotide, dans l'asthme chronique et la bronchite chronique spastique]. Lille Medical 1976;21(7 Suppl 3):623‐8. - PubMed
Doull 1995a {published data only}
    1. Doull I, Freezer N, Holgate S. Osteocalcin, growth, and inhaled corticosteroids: A prospective study. Archives of Disease in Childhood 1996;74(6):497‐501. - PMC - PubMed
    1. Doull IJ, Donovan SJ, Wood PJ, Holgate ST. Bloodspot cortisol in mild asthma: the effect of inhaled corticosteroids. Archives of Disease in Childhood 1995;72(4):321‐4. - PMC - PubMed
    1. Doull IJ, Freezer NJ, Holgate ST. Growth of prepubertal children with mild asthma treated with inhaled beclomethasone dipropionate. American Journal of Respiratory & Critical Care Medicine 1995;151(6):1715‐9. - PubMed
    1. Doull IJM, Lampe FC, Smith S, Schreiber J, Freezer NJ, Holgate ST. Effect of inhaled corticosteroids on episodes of wheezing associated with viral infection in school age children: Randomised double blind placebo controlled trial. British Medical Journal 1997;315(7112):858‐62. - PMC - PubMed
    1. Doull IJM, Sandall D, Smith S, Schreiber J, Freezer NJ, Holgate ST. Differential inhibitory effect of regular inhaled corticosteroid on airway responsiveness to adenosine 5' monophosphate, methacholine, and bradykinin in symptomatic children with recurrent wheeze. Pediatric Pulmonology 1997;23(6):404‐11. - PubMed
Emel'ionov 1995 {published data only}
    1. Emel'ianov AV, Trofimov VI. [The effect of glucocorticoids on mineral metabolism in bronchial asthma patients]. Ter Arkh 1995;67(12):31‐3. - PubMed
Francia 1994 {published data only}
    1. Francia G, Senna GE, Betteli C, Musumeci C, Fratta‐Pasini A, Piubello G, et al. Pituitary‐adrenal function in asthmatic patients treated with high dose of beclomethasone. Allerg Immunol (Paris) 1994;26(1):11‐5. - PubMed
Harrison 1999 {published data only}
    1. Harrison LI, Colice GL, Donnell D, Soria I, Dockhorn R. Adrenal effects and pharmacokinetics of CFC‐free beclomethasone dipropionate: A 14‐day dose‐response study. Journal of Pharmacy & Pharmacology 1999;51(3):263‐9. - PubMed
Harvald 1976 {published data only}
    1. Harvald B, Letman H. [Treatment of asthma with beclomethasone]. Ugeskrift for Laeger 1976;138(44):2717‐21. - PubMed
Hoshino 1999 {published data only}
    1. Hoshino M, Takahashi M, Takai Y, JaeJoon S. Inhaled corticosteroids decrease subepithelial collagen deposition by modulation of the balance between matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 expression in asthma. Journal of Allergy and Clinical Immunology 1999;104(2):356‐63. - PubMed
Huang 1993 {published data only}
    1. Huang JL, Hung IJ, Hsieh KH. Effect of inhaled beclomethasone dipropionate in the treatment of recurrent wheezing in infancy and early childhood. Journal of the Formosan Medical Association 1993;92(12):1066‐9. - PubMed
Kaptein 1993 {published data only}
    1. Kaptein AA, Brand PL, Dekker FW, Kerstjens HA, Postma DS, Sluiter HJ. Quality‐of‐life in a long‐term multicentre trial in chronic nonspecific lung disease: assessment at baseline. The Dutch CNSLD Study Group. European Respiratory Journal 1993;6:1479‐84. - PubMed
Konig 1974 {published data only}
    1. Konig P, Jaffe P, Godfrey S. Effect of corticosteroids on exercise‐induced asthma. Journal of Allergy & Clinical Immunology 1974;54(1):14‐9. - PubMed
Malo 1996 {published and unpublished data}
    1. Malo JL, Cartier A, Cote J, et al. Influence of inhaled steroids on recovery from occupational asthma after cessation of exposure: an 18‐month double‐blind crossover study. American Journal of Respiratory & Critical Care Medicine 1996;153(3):953‐60. - PubMed
Menz 1986 {published data only}
    1. Menz G. [Treatment of asthma with high doses of beclomethasone]. Schweizerische Rundschau fur Medizin Praxis 1986;75(30‐31):914‐6. - PubMed
Michel 1977 {published data only}
    1. Michel FB, Clauzel AM, Calvayrac P, Grenier J. [Mechanisms of action of glucocorticoids in the treatment of asthma. Comparative effects of glucocorticoids via the general route and beclomethasone dipropionate via aerial route on plasma levels of cyclic AMP]. Nouvelle Presse Medicale 1977;6(15):1278‐80. - PubMed
Nakajima 1979 {published data only}
    1. Nakajima S, Fujihara Y, Tsuya Y, Ohishi M, Takagi O. Changes of bronchoconstriction by treatment. Acta Medica Kinki University 1979;4(2):273‐9.
Nielsen 1999 {published data only}
    1. Nielsen LP, Pedersen B, Faurschou P, Madsen F, Wilcke JTR, Dahl R. Salmeterol reduces the need for inhaled corticosteroid in steroid‐dependent asthmatics. Respiratory Medicine 1999;93(12):863‐8. - PubMed
Nizankowska 1989 {published data only}
    1. Nizankowska E, Szczeklik A. Glucocorticosteroids attenuate aspirin‐precipitated adverse reactions in aspirin‐intolerant patients with asthma. Annals of Allergy 1989;63:159‐62. - PubMed
Noonan 2001 {published data only}
    1. Noonan I, Reiss T, Knorr B, Guerra J, Matz J. Long term asthma control with oral montelukast and inhaled beclomethasone for adults and children 6 yeras and older. Clinical & Experimental Allergy 2001;31:845‐45. - PubMed
Patakas 1978 {published data only}
    1. Patakas DLGSL. Effect of beclomethasone dipropionate inhalation on exercise induced bronchospasm. IRCS Medical Science: Cardiovascular System 1978;6(11):448.
Pizzichini 1996 {published and unpublished data}
    1. Pizzichini MM, Kidney JC, Wong BJ, et al. Effect of salmeterol compared with beclomethasone on allergen‐induced asthmatic and inflammatory responses [published erratum appears in Eur Respir J 1996 Oct;9(10):2190]. European Respiratory Journal 1996;9(3):449‐55. - PubMed
Richards 1978 {published data only}
    1. Richards W, Platzker A, Church JA, Yamamoto F, Foster S. Steroid‐dependent asthma treated with inhaled beclomethasone dipropionate in children. Annals of Allergy 1978;41(5):274‐7. - PubMed
Rodriguez 1986 {published data only}
    1. Rodriguez Sanchon B, Manresa F, Romero P, Cardona M. [Nocturnal asthma: Treatment with high inhalatory doses of salbutamol and beclomethasone]. Revista Clinica Espanola 1986;178:322‐6. - PubMed
Rohdewald 1992 {published data only}
    1. Rohdewald P. [Inhaled glucocorticoids. Slight side effects at high effectiveness]. Deutsche Medizinische Wochenschrift 1992;117(10):390‐3. - PubMed
Ronchetti 1976 {published data only}
    1. Ronchetti R, Gentili G. [Beclomethasone in the treatment of infantile asthma]. Minerva Pediatrica 1976;28(7):478‐85. - PubMed
Ruff 1977 {published data only}
    1. Ruff F, Brouet G. [Four years use of beclomethasone dipropionate aerosols]. Nouvelle Presse Medicale 1977;6(15):1283‐5. - PubMed
Sidel'nikov 1985 {published data only}
    1. Sidel'nikov VM, Pashun TV, Pomytkina LR. [Comparative evaluation of the effectiveness of different methods of prophylactic treatment for children with bronchial asthma]. Pediatriia 1985;4:34‐6. - PubMed
Sil'vestrov 1983 {published data only}
    1. Sil'vestrov VP, Surovov Iu A, Pakulin IA, Larin NV. [Effect of treatment with ventolin and becotide on ventilation and hemodynamics in patients with bronchial asthma]. Klinicheskaia Meditsina 1983;61(12):54‐8. - PubMed
Silkoff 2001 {published data only}
    1. Silkoff P, McClean P, Spino M, Erlich L, Slutsky A, Zamel N. Dose response relationship and peroducibility of the fall in exhaled nitric oxide after inhaled beclomethasone dipropionate therapy in asthma patients. Chest 2001;119:1322‐28. - PubMed
Stick 1995 {published data only}
    1. Stick SM, Burton PR, Clough JB, Cox M, LeSouef PN, Sly PD. The effects of inhaled beclomethasone dipropionate on lung function and histamine responsiveness in recurrently wheezy infants. Archives of Disease in Childhood 1995;73(4):327‐32. - PMC - PubMed
Storr 1986 {published data only}
    1. Storr J, Lenney CA, Lenney W. Nebulised beclomethasone dipropionate in preschool asthma. Archives of Disease in Childhood 1986;61(3):270‐3. - PMC - PubMed
Webb 1986 {published data only}
    1. Webb MS, Milner AD, Hiller EJ, Henry RL. Nebulised beclomethasone dipropionate suspension. Archives of Disease in Childhood 1986;61(11):1108‐10. - PMC - PubMed
Yuksel 1992 {published data only}
    1. Yuksel B, Greenough A. Randomised trial of inhaled steroids in preterm infants with respiratory symptoms at follow up. Thorax 1992;47(11):910‐3. - PMC - PubMed

References to studies awaiting assessment

Boszormeny‐Nagy 1980 {published data only}
    1. Boszormenyi‐Nagy G, Herjavecz I. [Clinical effects of beclomethasone dipropionate in bronchial asthma]. Orvosi Hetilap 1980;121(16):947‐50. - PubMed
Chonabayashi 1986 {published data only}
    1. Chonabayashi N, Yoshimura K, Nakamori Y, Nakatani T, Nakata K, Tanimoto H. [Method of decreasing oral corticosteroids by adding a beclomethasone dipropionate inhaler for steroid‐dependent asthmatic patients]. Nippon Kyobu Shikkan Gakkai Zasshi ‐ Japanese Journal of Thoracic Diseases 1986;24(5):522‐30. - PubMed
Iwata 1995 {published data only}
    1. Iwata M, Iinuma Y, Sugino Y, Suzuki Y. [Effects and limitations of inhaled high dose beclomethasone dipropionate (2400 micrograms/day) in steroid‐dependent asthmatics]. Arerugi 1995;44(5):562‐6. - PubMed
Kudo 1995 {published data only}
    1. Kudo K, Hojo M, Kabe J. [Inhaled beclomethasone in long‐term management of asthma: optimal dose and optimal duration of treatment]. Nippon Kyobu Shikkan Gakkai Zasshi 1995;33(9):956‐65. - PubMed
Muittari 1974 {published data only}
    1. Muittari A, Veneskoski T. [Beclomethasone aerosol in asthma therapy]. Duodecim 1974;90(18):1228‐34. - PubMed
Rozniecki 1988 {published data only}
    1. Rozniecki J, Szmidt M, Grzelewska‐Rzymowska I, Gorski P, Grabski W. [Clinical evaluation of beclomethasone dipropionate aerosol in patients with bronchial asthma]. Polski Tygodnik Lekarski 1988;43(12‐13):412‐5. - PubMed
Shen 1991 {published data only}
    1. Shen X, Niu SF, Cai YY. [A clinical trial of treating asthma of moderate severity with beclomethasone dipropionate aerosol]. Chung‐Hua Nei Ko Tsa Chih Chinese Journal of Internal Medicine 1991;30(9):536‐8, 593. - PubMed

Additional references

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Busse 1999
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