Abstract
compare the efficacy and the safety of fluticasone propionate in the management of moderate to severe asthma in adults and children to the inhaled corticosteroids currently available in the public health care system in order to present an alternative therapy to the Brazilian government. a systematic review of the MEDLINE, the Cochrane Library and Centre for Reviews and Dissemination (CRD) databases was conducted until September 2014, including randomized clinical study and systematic reviews about comparison between fluticasone propionate and budesonide or beclomethasone, not associated with other medications. There was no age limit and the assessed endpoint was pulmonary function through morning and evening Peak Expiratory Flow Rate, Forced Expiratory Volume in one second, exacerbation and adverse events. The quality of the studies was measured by Grades of Recommendation, Assessment, Development and Evaluation. there were 788 articles identified in MEDLINE, 231 in The Cochrane library and 46 in CRD, among all of these, 259 were duplicates, remaining 806 to title analysis. In the final analysis, 21 articles were included – 3 systematic reviews and 18 randomized clinical studies. All systematic reviews showed a strong recommendation in favor of the new technology and high methodological quality. Among the clinical studies, 9 of them compared fluticasone propionate to beclomethasone and the others 9 to budesonide. The study results showed no statistically significant difference between the compared medicines. According to the results, fluticasone propionate is effective and well tolerated for the treatment of moderate to severe asthma, in adults and children, as well as beclomethasone and budesonide. from this perspective, the inclusion of fluticasone propionate in the Brazilian Clinical Protocol and Therapeutic Guidelines could represent an extension of the therapeutic arsenal, especially, for the pediatric population that have few options of treatment. Funding for this study was provided by GlaxoSmithKline, study HO-14-15763.
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