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• W240991789 abstract "To the Editor: The importance of the development of a reformulation of beclomethasone dipropionate with hydrofluoroalkane (HFA)-134A into a solution that is capable of delivering a fine particle size with a mass median aerodynamic diameter of approximately 1 μm is cited in the article by Gross et al (February 1999)1Gross G Thompson PJ Chervinsky P et al.Hydrofluoroalkane-134a beclomethasone dipropionate, 400μg, is as effective as chlorofluorocarbon beclomethasone dipropionate, 800 μg, for the treatment of moderate asthma.Chest. 1999; : 343-351Abstract Full Text Full Text PDF PubMed Scopus (117) Google Scholar and the related editorial by Tashkin (February 1999).2Tashkin DF Extra-fine corticosteroid aerosols from hydrofluoroalkane-134a metered-dose inhalers: potential advantage and disadvantages.Chest. 1999; 115: 316-318Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar Administration of the extra fine corticosteroid aerosol results in a dramatic increase in lung deposition (51 to 56%) with a concomitant dramatic reduction in oropharyngeal deposition (28 to 30%), allowing for the use of considerably lower doses of beclomethasone to achieve efficacious end points.3Leach CL Davidson PJ Boudreau RJ HFA-134a beclomethasone dipropionate (HFA-BDP): extra fine aerosol MDI delivers 57% lung deposition across inspiratory flow ranges of 43–163 LPM [abstract].J Allergy Clin Immunol. 1998; 101: S63Google Scholar4Busse W Colice G Hannon S et al.CFC BDP requires 2.6 times the dose to achieve equivalent improvement in FEV1as HFA-BDP [abstract].Am J Respir Crit Care Med. 1998; 157: A405Crossref Scopus (163) Google Scholar The key question is whether the enhanced lung deposition and systemic absorption translate into a more favorable therapeutic index (topical desired effects vs systemic unwanted effects). How does the HFA solution of beclomethasone compare with chlorofluorocarbon beclomethasone or other inhaled steroids such as budesonide dry powder delivered by the Turbuhaler (Pulmicort Turbuhaler; Astra AB; Westborough, MA), in regard to lipophilicity, water solubility, receptor binding activity, retention as well as uptake in airways, volume of distribution, terminal half-life, and systemic clearance rate?5Brattsand R What factors determine anti-inflammatory activity and selectivity of inhaled steroids.Eur Respir Rev. 1997; 7 (356–361): 50Google Scholar6Miller-Larsson A Jansson P Runstrom AB et al.Reversible fatty acid conjugation of budesonide results in a prolonged topical anti-inflammatory activity in airways as compared to fluticasone propionate [abstract].Am J Respir Crit Care Med. 1997; 155: A353Google Scholar An updated state-of-the-art clarification of these pharmacokinetic parameters is needed for the current formulations and delivery devices of inhaled steroids. Focused clinical longitudinal studies are also needed to compare the effects of HFA beclomethasone and alternative inhaled steroids on systemic effects that target the HPA adrenal axis, bone mineral density, bone turnover, ocular changes, linear growth rate in children, and ultimate height attained. The evaluation of data obtained from the focused longitudinal safety studies that are cited above, as well as explicit pharmacokinetic and pharmacodynamic profiles of specific inhaled steroids (incorporating specific delivery preparations) and efficacy data, will enable clinicians to select the optimal inhaled steroid and delivery device for an individual patient.7Barnes PJ Pedersen S Busse WW Efficacy and safety of inhaled corticosteroids: new developments.Am J Respir Crit Care Med. 1998; 157: S1-S53Crossref PubMed Scopus (757) Google Scholar Extra Fine Hydrofluoroalkane-134A Beclomethasone Aerosols: Selecting an Optimal Inhaled Steroid for an Individual PatientCHESTVol. 116Issue 3PreviewTo the Editor: Full-Text PDF Extra Fine Hydrofluoroalkane-134A Beclomethasone Aerosols: Selecting an Optimal Inhaled Steroid for an Individual PatientCHESTVol. 116Issue 3PreviewTo the Editor: Full-Text PDF" @default.
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• W240991789 date "1999-09-01" @default.
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• W240991789 title "Extra Fine Hydrofluoroalkane-134A Beclomethasone Aerosols" @default.
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• W240991789 doi "https://doi.org/10.1378/chest.116.3.841" @default.
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