Influence of Delivery Devices on Efficacy of Inhaled Fluticasone Propionate: A Comparative Study in Stable Asthma Patients

Background: Inhaled corticosteroids are the preferred treatment for long-term control of all grades of persistent asthma. These are administered by various delivery devices with very little information whether these devices can affect the efficacy of inhaled corticosteroids. Fluticasone propionate is a relatively new inhalational corticosteroid compared to older ones like beclomethasone and budesonide. Aims & Objective: To assess the relative efficacy of fluticasone propionate administered from different delivery devices to adult patients of chronic stable bronchial asthma as measured by pulmonary function test parameters. Material and Methods: This prospective study was undertaken to assess the relative efficacy of fluticasone propionate administered from different delivery devices to adult patients of chronic stable bronchial asthma as measured by pulmonary function test parameters. Fourty eight subjects were administered, fluticasone propionate (250 pg) by dry powder inhaler, metered dose inhaler, metered dose inhaler with spacer and fluticasone (1mg) via nebulizer consecutively each week for four weeks under direct supervision. Pulmonary function test was done before and one hour after administration of the drug on each visit. Results: After excluding nine patients who were lost to follow up, data was analysed for the remaining thirty nine patients and no significant difference in peak expiratory flow rate (p=0.77), forced expiratory volume in one second (p=0.95), forced vital capacity (p=0.24) and forced expiratory volume in one second and forced vital capacity ratio (p=0.22) was seen after giving fluticasone by different devices. Conclusion: Fluticasone propionate delivered by different devices like dry powder inhaler, metered dose inhaler, metered dose inhaler with spacer and nebulizer have similar effect on lung function in patients of chronic stable bronchial asthma and may.