Fluticasone Propionate Aerosol Research Articles

The clinical efficacy of fluticasone propionate combined with ACEI/ARB in the treatment of immunoglobulin A nephropathy

BackgroundImmunoglobulin A nephropathy (IgAN) is the most common primary glomerulopathy worldwide, and lacks the effective treatment. The study was aimed to investigate the clinical efficacy of fluticasone propionate aerosol combined with angiotensin converting enzyme inhibitor / angiotensin receptor blocker (ACEI/ARB) in the treatment of IgAN.Methods142 patients with biopsy-proven IgAN at Shenzhen People?s hospital from June 2018 to June 2020 were enrolled. The patients were randomly divided into the supportive care plus fluticasone group and the supportive care group. The patients of the supportive care plus fluticasone group were treated with fluticasone propionate aerosol (250 ?g Bid) combined with ACEI/ARB, while the supportive care group was merely treated with ACEI/ARB. The patients were followed up at 3, 6 and 9 months after enrollment. Primary outcomes include changes in proteinuria and estimated glomerular filtration rate (eGFR).ResultsThe level of proteinuria in the supportive care plus fluticasone group was significantly lower compared with the supportive care group at 0, 3, 6 and 9 months. Meanwhile, during the follow-up period, no serious adverse events were recorded during the study in either group. However, fluticasone treatment did not alleviate the decline in eGFR.ConclusionFluticasone propionate aerosol combined with ACEI/ARB can reduce the level of proteinuria in thetreatment of IgAN, and has no significant effects on renal function.

Enhanced Optimal Parameter-Based Nebulizer Design for Flow Analysis of Fluticasone Propionate.

A jet nebulizer sprays a fine mist or aerosol directly into the lungs to reduce inflammation, expand airways, and make breathing easier for respiratory patients. Asthma, COPD, emphysema, and cystic fibrosis are treated with jet nebulizers. They are chosen over other nebulizers for their shorter treatment time and wider medication compatibility. For mechanically ventilated patients, jet nebulizers humidify oxygen to provide bronchodilators, antibiotics, and other respiratory medications. Additionally, they treat pneumonia, bronchitis, and other lung infections. Aerosol therapy requires medical jet nebulizers. However, experiment setup is time-consuming and challenging to enhance smaller droplet output. The study is aimed at enhancing the nebulizer and process parameters using numerical simulation and comparing the results to experimental data from the Malvern Spraytec™ laser diffraction system. This numerical model improves nebulization knowledge and predicts process parameters that affect output. Ansys Fluent was used to analyze a Creo-designed jet nebulizer solid model. The Spraytec™ experimental method was utilized to characterize fluticasone propionate's aerosol output and build the best nebulizer. Laser diffraction and computational fluid dynamics (CFD) analysis measured the nebulizer aerosol output. Comparing particle size data between 2 and 5μm. The results are similar, with a difference of 4.20%. Taguchi optimization found the optimal process parameter, and a conformation test enhanced the process parameter. The nebulizer generates 8.57% more fluticasone propionate at optimal particle size. The optimized nebulizer generates aerosols reliably and speeds up patient recovery.

Acupoint thread-embedding as adjuvant therapy for bronchial asthma in children and its effect on pulmonary function, serum IgA and IgE levels

To observe the efficacy of acupoint thread-embedding combined with fluticasone propionate aerosol for chronic persistent bronchial asthma of lung-spleen qi deficiency and spleen-kidney yang deficiency in children and its effect on pulmonary function and serum levels of IgA and IgE. A total of 120 children with chronic persistent bronchial asthma were randomly divided into an observation group (60 cases, 9 cases dropped off) and a control group (60 cases, 7 cases dropped off). The control group was treated with fluticasone propionate aerosol (125 μg per inhalation), twice a day; based on the control group treatment, the observation group was treated with acupoint thread-embedding at Dingchuan (EX-B 1), Feishu (BL 13), Zusanli (ST 36) and Danzhong (CV 17), once half a month. Both groups were treated for 3 months. The pulmonary function, serum IgA, IgE levels and TCM symptom score were compared between the two groups before and after treatment, and the clinical efficacy was evaluated. After treatment, the large airway function (peak expiratory flow [PEF], forced expiratory volume at the first second [FEV1]) and small airway function (maximal expiratory flow at 25% of the forced capacity [MEF25%], maximal expiratory flow at 50% of the forced capacity [MEF50%], maximal expiratory flow at 75% of the forced capacity [MEF75%] and midexpiratory flow 25%-75% [MEF25%-75%]) were higher than those before treatment (P<0.05), and the pulmonary function in the observation group was higher than that in the control group (P<0.05). After treatment, the serum IgA levels in the two groups were higher than those before treatment (P<0.05), and the serum IgE levels and TCM symptom scores were lower than those before treatment (P<0.05); the serum IgA level in the observation group was higher than that in the control group (P<0.05), and the serum IgE level and TCM symptom score in the observation group were lower than those in the control group (P<0.05). The total effective rate was 94.1% (48/51) in the observation group, which was higher than 88.7% (47/53) in the control group (P<0.05). Acupoint thread-embedding combined with fluticasone propionate aerosol could improve the pulmonary function, TCM symptoms and serum IgA and IgE levels in children with chronic persistent bronchial asthma of lung-spleen qi deficiency and spleen-kidney yang deficiency. The curative effect is better than fluticasone propionate aerosol alone.

Therapeutic Effects of a Long-Acting Cholinergic Receptor Blocker, Tiotropium Bromide, on Asthma.

BackgroundThe aim of this study was to evaluate the therapeutic effects of tiotropium bromide on asthma.Material/MethodsA total of 160 patients with moderate persistent asthma were randomly divided into 4 groups (n=40): the 3 control groups were given fluticasone propionate aerosol (group A), salmeterol-fluticasone propionate inhalant (group B), and tiotropium bromide inhalation powder combined with salmeterol-fluticasone propionate inhalant (group C), respectively, and the experimental group received tiotropium bromide inhalation powder combined with fluticasone propionate aerosol (group D) and salbutamol was used to relieve symptoms when necessary.ResultsAfter 8 weeks of treatment, the pulmonary function of group D, which was significantly better than those of group A (P<0.05), was similar to those of groups B and C (P>0.05). Group D had significantly better asthma control test scores and nighttime symptom scores than in group A (P<0.05), without significant differences from those of group B or group C (P>0.05). The number of times salbutamol was used to alleviate symptoms was significantly different (P<0.05) between group D and group A (P<0.05), as well as between group C and group D (P<0.05). Groups D and B had similar results (P>0.05). IL-13 levels in induced sputum had significant differences (P<0.05). The levels in group D, which were higher than those of groups A and B (P<0.05), were similar to those of group C (P>0.05).ConclusionsTiotropium bromide combined with fluticasone propionate improved the respiratory function and quality of life, and is a new therapy for moderate, persistent asthma.

Preventive effect of salmeterol xinafoate and fluticasone propionate aerosol on radiation pneumonia in local advanced non-small cell lung cancer: a clinical study

Objective To observe the preventive effect of salmeterol xinafoate and fluticasone propionate aerosol on radiation pneumonia in patients with local advanced non-small cell lung cancer (NSCLC) after radiotherapy. Methods Sixty-four patients with local advanced NSCLC were randomly divided into the study group and the control group. Both groups were treated with intensity modulated radiation therapy treatment and routine interventions. Salmeterol xinafoate and fluticasone propionate aerosol were given to the study group from the first day of radiation therapy at both the morning and evening time. Clinical symptoms, chest CT, Karnofsky score and tumor necrosis factor-α (TNF-α) levels in the two groups were analyzed at the time before radiotherapy and three months after radiotherapy. Results The radiation pneumonia incidence of the study group was lower than that of the control group[21.9 %(7/32) vs 46.9 %(15/32)]. The plasma TNF-α content after radiotherapy of the study group was lower than that of the control group [(9.18±3.45) ng/ml vs (13.38 ± 2.75) ng/ml]. Moreover, the Karnofsky score of the study group was higher than that of the control group [(81.67 ± 7.18) scores vs (75.00± 6.74) scores]. The differences between the two groups were statistically significant(all P<0.05). Conclusion Salmeterol xinafoate and fluticasone propionate aerosol can reduce the radiation incidence of the patients with local advanced NSCLC, improve patients’ quality of life after radiotherapy and prevent the radiation pneumonia. Key words: Salmeterol xinafoate and fluticasone propionate aerosol; Radiotherapy, intensity-modulated; Radiation pneumonitis; Carcinoma, non-small-cell lung

Effects of aerosol tiotropium and salmeterol/fluticasone propionate aerosol on lung function in patients with COPD and related indicators

Objective To analyze the effects of salmeterol/fluticasone propionate aerosols fluticasone propionate and salmeterol joint tiotropium aerosol on pulmonary function and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD), and to provide a theoretical basis for clinical treatment. Methods 119 COPD patients were selected in this study.They were randomly divided into 65 cases of seretide group and 54 cases of combined treatment group.Before treatment, three months after treatment and six months after treatment, the pulmonary function and 6MWD were measured in all patients. Results After 3 months, 6 months of treatment, the FEV1, FEV1/FVC, FVC, 6MWD of the combined treatment group had significant differences compared with before treatment(ta=-5.89, tb=-6.88, te=-8.46, tf=-8.86, ti=-10.74, tj=-8.52, tm=-9.37, tn=-13.04, all P<0.05). After 3 months, 6 months of treatment, the FEV1, FEV1/FVC, FVC, 6MWD in the control group had significant differences compared with before treatment (tc=-4.29, td=-7.19, tg=-6.16, th=-11.40, tk=-11.69, tl=-7.43, to=-11.71, tp=-10.53, all P<0.05). After 3 months of treatment, the differences of FEV1, FEV1/FVC, FVC between two groups were significant (tv=2.69, tq=6.74, tr=2.91, all P<0.05). In the control group, the FEV1, FEV1/FVC, FVC after 6 months of treatment had significant differences compared with after 3 months of treatment(ts=-2.50, tt=-9.46, tu=-1.65, all P<0.05). Conclusion Seretide and tiotropium aerosol aerosol can better improve lung function in patients with COPD and exercise tolerance, but the result of using two drugs to improve the patients' lung function was significantly better than seretide alone. Key words: Pulmonary disease, chronic obstructive; Pulmonary function; Tiotropium bromide aerosol; Salmeterol/fluticasone aerosol

Fluticasone propionateエアゾール剤の臨床的検討 (第8報)

Fluticasone propionateエアゾール剤の臨床的検討 (第8報)

Therapeutic effect of two threapies for bronchial asthma complicated with allergic rhinitis

Objective To compare therapeutic effects of fluticasone propionate aerosol combined with fluticasone nasal pray and alone fluticasone propionate aerosol for bronchial asthma complcated with allergic rhinitis.Methods Fifty asthmatic children with allergic rhinitis were randomly divided into observation group and control group.Observation group were treated with fluticasone propionate aerosol combined with fluticasone nasal pray,control group were treated with fluticasone propionate aerosol alone.All the patients were observed for 6 months.The lung function parameters( FEV1％ ),the number of acute asthma symptom,the number of days without acute asthma symptom,the number of acute allergic symptoms at one month,three months,six months after the treatment.were observed.Results FEV1％of observation group were(107.2 ± 15.3)％,( 115.3 ± 11.9)％,( 131.3 ± 10.9)％,and were significantly improved(98.6 ± 13.6)％,( 102.6 ± 13.6)％,( 126.5 ±9.7)％ 、(t =2.306,3.355,3.714,all P ＜0.05) at one month,three months,six months after the treatment.The number of acute asthma symptom,the number of days without acute asthma symptom,the number of acute allergic symptoms of observation group were(0.13 ±0.11),(150.2 ±14.3),(0.25 ±0.31),and control group were(0.30 ±0.44),(116.5 ±23.1),(0.65 ±0.24),Observation group had significant difference compared with control group(t =2.413,3.435,3.734,all P ＜0.05).Conclusion There was significant therapeutic effect of fluticasone propionate aerosol combined with fluticasone nasal pray for bronchial asthma complicated with allergic thinitis,and was worthy of clinical application Key words: Asthma; Rhinitis, allergic; Fluticasone

Fluticasone Propionate Aerosol is More Effective for Prevention than Treatment of Recurrent Airway Obstruction

Efficacy of inhaled fluticasone propionate (FP) for management of recurrent airway obstruction (RAO) has only been evaluated after several weeks' treatment. To compare efficacy of (1) 3-day treatments with FP to dexamethasone (DEX) for management of RAO; and (2) FP and DEX to no treatment in prevention of acute RAO exacerbations. Nine RAO affected horses. Crossover studies in RAO-affected horses compared (a) 3-day treatment of RAO exacerbation with FP (3 and 6 mg q12h) and DEX (0.1 mg/kg q24h) and (b) FP (6 mg q12h) and DEX (0.1 mg/kg q24h) to no treatment for prevention of acute exacerbations of RAO. Treatment efficacy and unwanted effects were judged from maximal change in pleural pressure (DeltaPpl(max)), serum cortisol (COR), bronchoalveolar lavage (BAL) cytology, and subjective scores for respiratory distress and lameness. In treatment trial, DEX and FP (6 mg) significantly decreased DeltaPpl(max) by 48 and 72 hours, respectively; FP (3 mg) had no significant effect. DEX decreased COR more than did FP. In prevention trial, both DEX and FP (6 mg) prevented the increase in DeltaPpl(max) that occurred in untreated horses. Both treatments decreased COR to the same degree. FP and DEX had no effects on bronchoalveolar lavage fluid (BALF) cytology and there was no evidence of laminitis. FP (6 mg q12h) is as effective as DEX for prevention of acute exacerbations of RAO and lower doses should be evaluated. High-dose FP is not as effective as DEX for treatment of RAO exacerbations.

The olfactory system is affected by steroid aerosol treatment in mice

Asthma needs continuous treatment often for years. In humans, some drugs are administered via aerosol, therefore they come in contact with both respiratory and olfactory mucosa. We explored the possibility that antiasthma corticosteroid treatment could influence the olfactory function by passage through the nose. A group of mice was exposed twice daily for 42 days to fluticasone propionate aerosol and was compared with a control group. Olfactory behavior, respiratory mechanics, histology, and immunoreactivity in the olfactory system were assessed. Fluticasone-treated mice were slower in retrieving a piece of hidden food, but both groups were similarly fast when the food was visible. When a clearly detectable odor was present in the environment, all mice behaved in a similar way. Respiratory mechanics indices were similar in all mice except for the viscose resistance, which was reduced in fluticasone-treated mice. Olfactory mucosa of fluticasone-treated mice was thicker than that of controls. Slight but consistent differences in staining were present for Olfactory Marker Protein but not for other proteins. A mild impairment of olfactory function is present in mice chronically treated with fluticasone aerosol, apparently accompanied by slight modifications of the olfactory receptor cells, and suggests monitoring of olfactory function modifications in long-term steroid users.

Fluticasone propionate versus zafirlukast: effect in patients previously receiving inhaled corticosteroid therapy

The use of inhaled corticosteroids compared with leukotriene modifying drugs in the treatment of persistent asthma has not been extensively studied. To compare the efficacy and safety of a low dose of fluticasone propionate (FP) and zafirlukast in patients previously maintained on inhaled corticosteroids. Patients (> or = 12 years old; FEV1 = 60% to 85% of predicted) with persistent asthma who were previously treated with low doses of triamcinolone acetonide (TAA) 400 to 800 microg/day or beclomethasone dipropionate (BDP) 168 to 336 microg/day were randomized to treatment with FP aerosol 88 microg BID (FP, n = 221) or zafirlukast 20 mg BID (n = 216) over 6 weeks. Treatment with FP significantly increased the mean change at endpoint (the last post-baseline observation) in FEV1 (0.22 L versus 0.03 L, P < .001), morning PEF (17.8 versus 3.1 L/min, P = .004), evening PEF (16.7 versus 2.6 L/min, P = .002), the percentage of symptom-free days (16.2 versus 7.1%, P = .007), and the percentage of rescue-free days (23.4 versus 9.3%, P < .001), and significantly decreased rescue albuterol use (-0.66 puffs/day versus an increase of 0.27 puffs/day, P < .001) and combined symptom scores (-0.13 versus an increase of 0.08, P < .001) compared with zafirlukast. Treatment with FP maintained the percentage of awakening-free nights (-1.0 +/- 1.0); in contrast, treatment with zafirlukast reduced the percentage of awakening-free nights (-9.0 +/- 1.6, P < .001). A clinically meaningful difference (change of > or = 0.5; P < .001) was observed between FP and zafirlukast in the Asthma Quality of Life Questionnaire (AQLQ) global score and for each domain score except activity limitation (change of 0.3, P < .001). Significantly more patients in the zafirlukast group experienced an asthma exacerbation (n = 14) compared with FP-treated patients (n = 5, P = .035). Patients in the zafirlukast group were significantly more likely to be withdrawn due to lack of efficacy (P < .001). Switching patients from low doses of inhaled corticosteroids to a lower total microgram dose of FP improves pulmonary function, asthma symptoms, and quality of life, while switching to the leukotriene receptor antagonist zafirlukast may result in worsening of asthma control. This was indicated by the significant number of zafirlukast-treated patients who were dropped from the study due to lack of efficacy within 6 weeks of discontinuing inhaled corticosteroids.

Effects of fluticasone propionate, triamcinolone acetonide, prednisone, and placebo on the hypothalamic-pituitary-adrenal axis

Background: Many clinicians are reluctant to prescribe inhaled corticosteroids because of concerns over potential effects on the hypothalamic-pituitary-adrenal axis. Objective: The purpose of this study was to compare the adrenal responses to 6-hour cosyntropin infusion after treatment with fluticasone propionate aerosol, triamcinolone acetonide aerosol, prednisone, and placebo for 4 weeks, a sufficient time interval to assess any effects on the adrenal response to stress. Methods: This double-blind, triple-dummy, randomized, placebo-controlled study was conducted in 128 patients to evaluate adrenal response to 6-hour cosyntropin infusion (a clinically relevant method for evaluating adrenal function) after 28 days of treatment with fluticasone propionate aerosol 88 μg or 220 μg twice daily, triamcinolone acetonide aerosol 200 μg 4 times daily or 400 μg twice daily, prednisone 10 mg once daily, and placebo. Results: After 28 days of treatment, mean plasma cortisol response to cosyntropin over 12 hours after initiation of the 6-hour infusion was similar among fluticasone, triamcinolone, and placebo groups; cortisol response was significantly ( P < .05) reduced after treatment with prednisone compared with the other treatment groups. Mean 8-hour area under the plasma cortisol concentration-time curves and peak plasma cortisol concentrations were significantly ( P ≤ .003) lower with prednisone than any other treatment; no significant differences were noted between placebo and either of the fluticasone groups in any assessment. Mean reductions from baseline in area under the plasma cortisol concentration time curves and peak cortisol concentrations were significantly ( P < .05) greater with triamcinolone 400 μg twice daily compared with placebo. Conclusion: These results suggest that fluticasone propionate at therapeutic doses has effects on the hypothalamic-pituitary-adrenal axis comparable to that of placebo and has significantly less effect than prednisone as measured by 6-hour cosyntropin infusion after 28 days of treatment. (J Allergy Clin Immunol 1999;103:622-8.)

Fluticasone Propionate Reduces Oral Prednisone Use While it Improves Asthma Control.

This study examined the effect of fluticasone propionate aerosol on oral prednisone requirements in patients with severe asthma. Ninety-six patients dependent on oral prednisone were treated with placebo or fluticasone propionate aerosol (750 or 1000 &mgr;g twice daily) for 16 weeks. The dosage of oral prednisone was adjusted weekly according to predetermined criteria. Fluticasone propionate 750 and 1000 &mgr;g twice daily resulted in 69% and 88% of patients (low and high doses, respectively) not using any prednisone compared to 3% of placebo-treated patients by the end of the study. In the fluticasone propionate groups, forced expiratory volume in 1 s (FEV(1)) and peak expiratory flow rates and the number of nighttime awakenings improved at the last evaluable visit. In addition, the number of nighttime awakenings and symptomatic albuterol use declined relative to placebo values (p < 0.05). Fluticasone propionate aerosol was well tolerated. Fluticasone propionate aerosol (750 or 1000 &mgr;g twice daily) effectively and safely allowed most asthmatics who were dependent on oral corticosteriods to reduce or eliminate oral prednisone use while improving pulmonary function.

Fluticasone propionate aerosol for the treatment of adults with mild to moderate asthma

Background: Recent emphasis on the control of airway inflammation in asthma highlights the need for safe and effective antiinflammatory agents. Fluticasone propionate is one of the most potent antiinflammatory corticosteroids developed to date.Objective: This study assessed the safety and efficacy of fluticasone propionate aerosol in the treatment of mild to moderate asthma.Methods: Fluticasone propionate aerosol (25, 100, or 500 μg twice daily) or placebo was given for as long as 8 weeks to adults with mild to moderate asthma in a randomized, double-blind, parallel-group study. Patients were removed from the study if they showed predefined signs of worsening asthma.Results: Sixty-three percent of placebo-treated patients and 23%, 13%, and 4% of patients treated with fluticasone propionate 25, 100, and 500 μg twice daily, respectively, were removed from the study. Mean forced expiratory volume in 1 second, forced vital capacity, and forced expiratory flow at midexpiratory phase at weekly visits throughout the study demonstrated that fluticasone propionate was more efficacious than placebo in maintaining asthma control. Measurements of peak expiratory flow and symptom scores significantly improved and nighttime awakenings and albuterol use to treat symptoms significantly declined in fluticasone propionate-treated groups relative to the placebo-treated group. Differences among fluticasone propionate groups for these variables were not statistically significant. Incidence and severity of adverse events were similar across groups. Fluticasone propionate did not affect morning or stimulated plasma cortisol concentrations, although slight, transient reductions in urinary free cortisol and urinary 17-hydroxy steroids occurred in the group receiving 500 μg fluticasone propionate twice daily.Conclusion: These data indicate that fluticasone propionate provides safe and effective treatment for mild to moderate asthma.

Clinical Studies of Fluticasone Propionate Aerosol (5th Report)

Clinical Studies of Fluticasone Propionate Aerosol (5th Report)

Clinical Studies of Fluticasone Propionate Aerosol (2nd Report)

Clinical Studies of Fluticasone Propionate Aerosol (2nd Report)

Clinical Studies of Fluticasone Propionate Aerosol (1st Report)

Clinical Studies of Fluticasone Propionate Aerosol (1st Report)

Clinical Studies of Fluticasone Propionate Aerosol (3rd Report)

Clinical Studies of Fluticasone Propionate Aerosol (3rd Report)

Clinical Studies of Fluticasone Propionate Aerosol (6th Report)

Clinical Studies of Fluticasone Propionate Aerosol (6th Report)

Clinical efficacy of tiotropium in children with asthma.

Objective:To investigate the clinical efficacy of tiotropium in children with asthma.Methods:Eighty children with newly diagnosed moderate persistent asthma were enrolled into this study. The children were randomly assigned to the fluticasone propionate aerosol group or the fluticasone propionate aerosol plus tiotropium group for 12 weeks.Results:Lung function was significantly improved in both groups at 4, 8, and 12 weeks compared with baseline (P < 0.01). Moreover, lung function was significantly improved in the tiotropium group compared with the control group (P < 0.05). However, there was no significant difference in the incidence of severe asthma between the two groups (36.3% and 26.8%, respectively; P > 0.05). Compared with the control group, the number of days and frequency of short-acting beta2-adrenoceptor agonist use was significantly reduced in the tiotropium group (P < 0.05). Awakenings during the night were also significantly decreased (P < 0.00). There were no severe adverse reactions in either of the study groups.Conclusion:Tiotropium could significantly improve lung function, reduce the use of short-acting beta2-adrenoceptor agonists, and improve sleep in children with asthma. Furthermore, few adverse reactions were reported.