Improvement of asthma control with beclomethasone extrafine aerosol compared to fluticasone and budesonide

Qvar® Autohaler® efficacy on asthma control, assessed with E. Juniper asthma control questionnaire (ACQ), was compared with fluticasone and budesonide. An open randomized study, stratified (2:1) on the intake of long-acting β2-mimetics (LAβ2), was performed in patients with moderate to severe poorly controlled asthma (defined by at least one nocturnal discomfort in the last 5 days or a mean of 2 puffs of short-acting β2-mimetics in the last 7 days or exercise dyspnea) despite treatment with beclomethasone ⩽1000 μg/day (or equivalent). 460 patients received Qvar Autohaler 800 μg/day (n=149), fluticasone Diskus 1000 μg/day (n=149) or budesonide Turbuhaler 1600 μg/day (n=162) during 12 weeks. Asthma control improved in all groups, with no difference between groups. For patients treated with LAβ2 (n=286) a significantly greater improvement of the ACQ score was obtained with Qvar Autohaler versus fluticasone (1.0±1.0 vs. 0.6±0.9; P=0.019), but not versus budesonide (0.9±0.9). Pulmonary function test improvements were similar in the 3 groups. The significant improvement in asthma control in patients receiving LAβ2 suggests potential advantages for extrafine aerosols as part of anti-inflammatory treatment optimization.