Effects of inhaled HFA beclomethasone on pulmonary function and symptoms in patients with chronic obstructive pulmonary disease

• Published in: Respiratory medicine Vol. 99; no. 11; pp. 1418 - 1424
• Main Authors: John, Matthias, Bosse, Susanne, Oltmanns, Ute, Schumacher, Axel, Witt, Christian
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.11.2005; Elsevier; Elsevier Limited
• Subjects: Administration, Inhalation; Anti-Inflammatory Agents - therapeutic use; Asthma; Beclomethasone - therapeutic use; Biological and medical sciences; Bones, joints and connective tissue. Antiinflammatory agents; Cell culture; Chronic obstructive pulmonary disease, asthma; COPD; Cross-Over Studies; Cytokines; Cytokines - blood; Disease; Double-Blind Method; Drug therapy; Enzyme-Linked Immunosorbent Assay; Female; Forced Expiratory Volume - drug effects; Glucocorticoids - therapeutic use; HFA 134 beclomethason; Humans; Hydrocortisone - blood; Hyperinflation; Inhaled corticosteroids; Lung - drug effects; Male; Medical sciences; Middle Aged; Monocytes - drug effects; Monocytes - secretion; Mortality; Pharmacology. Drug treatments; Pneumology; Pulmonary Disease, Chronic Obstructive - blood; Pulmonary Disease, Chronic Obstructive - drug therapy; Quality of Life; Steroids; Thyroid diseases; Germany; Inhaled corticosteroids; Cytokines; HFA 134 beclomethason; COPD; Quality of life; Human; Lung disease; Corticosteroid; Respiratory disease; Chronic disease; Cytokine; Inhalation; Beclometasone; Symptomatology; Chronic; Lung function; Bronchus disease; Obstructive pulmonary disease
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2005.03.034

Chronic obstructive pulmonary disease is characterized by progressive airflow limitation and pulmonary inflammation. Inhaled corticosteroids (ICS) have been shown to be effective in the reduction of the number of exacerbations and the rate of deterioration in health status in patients with more advanced chronic obstructive pulmonary disease (COPD). Therefore current international guidelines recommend ICS for patients with severe COPD (FEV 1<50%) with at least one exacerbation within the last year. We determined the short-term effect of the inhaled corticosteroid beclomethasone in HFA 134 formulation (Ventolair ®) on Health related Quality of Life (HRQOL), pulmonary function and the release of the cytokines Interleukin-10 (IL-10), Granulocyte-Macrophage Colony-stimulating Factor (GM-CSF), Interferon- γ (IFN- γ ) and Macrophage Inflammatory Protein-1 α (MIP-1 α ) from peripheral blood monocytes of patients with COPD ( n = 11 ) in a 12 week double blind cross over placebo-controlled study. Baseline lung function and the St. George Respiratory Questionnaire (SGRQ) were performed at the start and the end of each treatment phase. Monocytes were separated from blood at the end of each treatment phase. The treatment with Ventolair ® resulted in an increase of PEF from 4.92 to 5.53 l/s and a decrease of RV% TLC (% predicted) values from 144.52 to 131.36. Inhaled HFA beclomethasone did not affect the cytokine release of IL-10, IFN-γ, GM-CSF and MIP-1 α . All cytokines were measured using commercially available Enzyme Linked Immun Sorbent Assay (ELISA) kits. The symptom score of the St. George Respiratory Questionnaire significantly decreased from 55.12 to 47.77 units in the active period compared to the placebo period after the treatment with HFA beclomethasone. The present study shows that a short-term treatment with inhaled steroid beclomethasone in fine particle HFA formulation decreases the hyperinflation and improves the PEF and the COPD symptoms.