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 β 2-mimetics (LA β 2), 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 β 2-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 LA β 2 ( 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 LA β 2 suggests potential advantages for extrafine aerosols as part of anti-inflammatory treatment optimization.