Extra-Fine Inhalers Ineffective Against COPD

Beclomethasone oral inhalation does not suppress small airway inflammation

(RxWiki News) Combating inflammation is an important step in treating Chronic Obstructive Pulmonary Disease (COPD). Sometimes a drug is successful but like anything, there are risks.

Using extra-fine inhaled corticosteroids, Beclomethasone Oral Inhalation (BOI) marketed as Qvar, Beclovent and Vanceril, or oral corticosteroids, did not aid in reducing nitric oxide in the lungs.

Nitric oxide has been a way to predict airway inflammation in COPD patients.

Despite its ability to penetrate into the small airways of the lungs, oral corticosteroids may not effective in reducing small airway inflammation in COPD patients.

"Ask your doctor about current COPD treatments."

The study was led by Dr. Philip Short from the Asthma and Allergy Research Group from the University of Dundee at Scotland. Previous research using standard inhaled corticosteroids were ineffective in reducing nitric oxide.

Researchers believed that oral corticosteroids could be effective by being able to reach the small airways. Unfortunately, that was no the case.

COPD patients were randomly placed into two six week programs, one group received BOI and an another group received a placebo. The BOI group had two three week trials, the first week featured 100 microgram dose of BOI twice a day and the second set of weeks featured a 400 microgram dose of BOI twice a day.

After the six week period, both groups received a 25 milligram dose of prednisolone, an oral corticosteroid to be taken once a day for a week. After the trials, lung function, how much nitric oxide was exhaled and plasma cortisol was taken to measure the effectiveness of BOI or the oral corticosteroid.

In 16 COPD patients, there was no decrease in nitric oxide by BOI when compared to a placebo. While the oral corticosteroid reduced exhaled nitric oxide it did not reduce nitric oxide found in the small airways. Plasma cortisol, which is released in response to stress, was reduced only by the oral corticosteroid and not BOI.

Future research can still use nitric oxide as a way to measure small airway inflammation. Unfortunately, researchers may now rule out BOI, oral corticosteroids and inhaled corticosteroids when it comes to battling small airway inflammation.

No funding information was published. No author conflicts were reported.

This study was published in the February edition of Lung.