As Needed Beclomethasone/Salbutamol Combination in Single Inhaler for Mild Persistent Asthma

NCT ID: NCT00382889

Last Updated: 2020-08-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE3
• Total Enrollment: 480 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2002-08-31
• Study Completion Date: 2004-09-30

Brief Summary

The aim of this study is to reveal that inhaled corticosteroid therapy combined with a short-acting beta2- agonist given on a symptom driven basis is as effective as traditional asthma therapy.

Thus, three advantages will be achieved:

1. better compliance with treatment since patients will most likely have to administer the treatment less frequently,

2. maximum pharmacological effect with the least amount of drug and

3. less economic burden on health care providers.

Detailed Description

Asthma is widely recognised as a chronic inflammatory disorder of the airways. The 1997 American National Heart Lung and Blood Institute (NHLBI) Guidelines states that a firm scientific basis exists to indicate that asthma results from complex interactions among inflammatory cells, mediators and the cells and tissues resident in the airways.

Despite the existence of effective therapy people still die from asthma. It is pertinent to state that the clinical effect of a drug is not only dependent on the specific action of the drug, but also on the patient's way of using it. Therefore, compliance is an important factor especially for chronic disorders such as asthma. Indeed, non compliance with asthma therapy is a serious problem. It has been reported that drug side effects, lifestyle, social and economic factors, method of drug delivery and dosing are factors that contribute to poor compliance. The consequences of poor compliance lead to increased morbidity due to increased symptoms and asthma exacerbation.

The NHLBI Guidelines recommend daily treatment for patients with mild persistent asthma with inhaled glucocorticoids (200-500mcg/die) and short-acting bronchodilators as needed but no more than 3-4 times a day.

Comparisons: beclomethasone dipropionate 250 mg combined with salbutamol 100 mg "as needed", vs salbutamol 100 mg alone "as needed", vs beclomethasone 250 mg twice a day plus salbutamol 100 mg "as needed" and vs beclomethasone dipropionate 250 mg combined with salbutamol 100 mg twice a day plus salbutamol 100 mg "as needed", in the treatment of patients with mild persistent asthma.

Conditions

Asthma

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Interventions

beclomethasone/salbutamol combination

Intervention Type: DRUG

beclomethasone

Intervention Type: DRUG

salbutamol

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Clinical diagnosis of mild persistent asthma as defined by NHLBI/WHO 97; for at least 6 months;
• FEV1 ³ 75% of predicted normal value;
• Positive response to the reversibility test to b2 agonist, defined as an increase > 12% in the FEV1 measured 30 minutes following 2 puffs (2x100mg) of inhaled Salbutamol spray, or positive methacholine challenge (PC20<8mg/ml or PD20<1 mg) within the previous 6 months;
• Stable asthma. Asthma is defined stable if none of the following occurred during the last 14 days of the run-in period: diurnal variation of more than 20% in PEF on 2 consecutive days; use of four or more inhalations of b2 agonist per day on two consecutive days; need the use of oral corticosteroids;

Exclusion Criteria

• COPD as defined by the ERS - Consensus Statement;
• Patients with more than 10 packs/year of cigarettes history and current smokers;
• History of near fatal asthma and/or admission in intensive care unit because of asthma;
• One severe exacerbation during the run-in period;
• Three or more courses of oral corticosteroids or hospitalisation for asthma during the previous 1 year;
• Patients treated with more than 500 mcg/day of beclomethasone or equivalent for more than 6 months in the previous last year;

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Chiesi Farmaceutici S.p.A.

INDUSTRY

Sponsor Role: lead

Principal Investigators

Leonardo M Fabbri, MD

Role: PRINCIPAL_INVESTIGATOR

Clinica di Malattie dell'Apparato Respiratorio, Dipartimento di Oncologia, Ematologia e Pneumologia, Università di Modena e Reggio Emilia, Italy

Locations

Ambulance for pediatrics and Pneumology

Vienna, , Austria

Pulmologisches Zentrum Der Stadt Wien

Vienna, , Austria

Dip. di Pneumologia - Osp. Tommaselli

Catania, , Italy

Nuove Cliniche Arcispedale S.Anna

Ferrara, , Italy

DIMI - Dip. Medicina Interna - Univ. di Genova - clinica di malattie apparato respiratorio e allergologico

Genova, , Italy

Dipartimento di scienze mediche oncologiche e radiologiche - sez. malattie apparato respiratorio

Modena, , Italy

Univ. di Padova - Dipartimento di medicina ambientale e sanità pubblica

Padua, , Italy

Istituto di Fisiopatologia Respiratoria CNR - Ospedale Cervello

Palermo, , Italy

Clinica Pneumologica padiglione Rasori - Univ. di Parma

Parma, , Italy

Clinica di Malattie dell'Apparato Respiratorio dell'Univ. di Pavia - Policlinico S. Matteo

Pavia, , Italy

Reparto Fisiologia Respiratoria - dip. Cardiotoracico - Ospedale Cisanello

Pisa, , Italy

Outpatient Clinic of Internal Diseases and Allergology

Bialystok, , Poland

Specialist Group Medex

Bielsko-Biala, , Poland

Clinic of Internal Diseases Atopia Al.

Krakow, , Poland

Pulmonologic Clinic - Poludnie os. Krakowiakòw

Krakow, , Poland

Clinic of Pneumology and Allergology

Lòdz, , Poland

Clinic of Tubercolosis and Lung Diseases

Lòdz, , Poland

Clinic of Pneumology - Institute of Internal Medicine of Medical Academy

Lódz, , Poland

Institute of Occupational Medicine - Clinic of Occupational Disesase

Lódz, , Poland

Clinic of Infection Diseases and Allergology - Central Clinical Hospital of Military Medical Academy

Warsaw, , Poland

Clinic of Pneumology and Allergology A.M.

Warsaw, , Poland

Clinic of Pneumology and Allergology of Medical Academy

Warsaw, , Poland

Hospital Vall d'Hebron de Barcelona

Barcelona, , Spain

H.General de Vic, Servicio de Neumologia

Barcelona, , Spain

Hospital de Matarò

Mataró, , Spain

Countries

Austria; Italy; Poland; Spain

References

Papi A, Canonica GW, Maestrelli P, Paggiaro P, Olivieri D, Pozzi E, Crimi N, Vignola AM, Morelli P, Nicolini G, Fabbri LM; BEST Study Group. Rescue use of beclomethasone and albuterol in a single inhaler for mild asthma. N Engl J Med. 2007 May 17;356(20):2040-52. doi: 10.1056/NEJMoa063861.

Reference Type: RESULT

PMID: 17507703 (View on PubMed)

Other Identifiers

MC/PR/1401/001/01

Identifier Type: -

Identifier Source: org_study_id