A new HFA-134a propellant in the administration of inhaled BDP via the Jet ® spacer: controlled clinical trial vs the conventional CFC

Abstract

This study was carried out with the aim of demonstrating the efficacy and tolerability of beclomethasone dipropionate (BDP) aerosol spray 500μg b.i.d. via a spacer device (Jet ®, Chiesi Farmaceutici S.p.A.) using a new HFA-134a formulation or chlorofluorocarbon (CFC) propellant. After having completed a 2-week run-in period, 154 adult patients (77 in each group) with mild-to-moderate persistent asthma were randomised into two groups to receive the study treatment for a duration of 12 weeks in a double-blind, multinational, multicentre, parallel-group design. Morning and evening peak expiratory flow rate (PEFR), use of rescue salbutamol, number of day- and night–time asthma attacks, number of night-time awakenings due to asthma and clinical symptoms were recorded daily by patients on diary cards. Pulmonary function tests (FEV 1, FVC, PEFR, FEF 25–75%, MEF 50 and FEF 25) and vital signs were measured at the clinic at study entry, at the start of treatment and every 2 weeks thereafter. Morning serum cortisol (8.00–10.00 a.m.) was measured at the start and at the end of the treatment period. Adverse events were recorded throughout the total study period. Significant improvements over baseline were reported in both groups in terms of lung function, symptoms and use of rescue inhaled salbutamol. Equivalence between groups was demonstrated for the primary end-point morning PEFR, as well as for evening PEFR and FEV 1. No statistically significant differences in the comparisons between groups, except for FEF 25 ( P=0.044), were observed in any of the other efficacy variables. Adverse events were reported in 31% of patients in the BDP–HFA group and in 32% in the CFC group. Adverse drug reactions were 4 and 2 in the two groups, respectively. No drug-related serious adverse events were reported in either of the groups. No signs of relevant adrenal suppression were observed in both groups: 2 patients in each group had final values below the normal range. In conclusion, the BDP–HFA-134a formulation proved to be equivalent in efficacy and comparable in safety to the standard BDP–CFC product over 12 weeks in adult patients with mild-to-moderate persistent asthma.