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Extra‐fine particle inhaled corticosteroids, pharma‐cokinetics and systemic activity in children with asthma

Extra‐fine particle inhaled corticosteroids, pharma‐cokinetics and systemic activity in children... During recent years, extra‐fine particle inhaled corticosteroids with a median aerodynamic diameter ≤2 μm have been introduced in the treatment of asthma. The aim of this paper was to review pharmacokinetics and systemic activity of extra‐fine particle hydroalkane pressurized metered dose inhaled (pMDI) ciclesonide and beclomethasone dipropionate in children. A literature review was performed. Systemic bioavailability of oral and pulmonary deposition of extra‐fine ciclesonide and beclomethasone dipropionate was 52% and 82%, the half‐life in serum 3.2 and 1.5 h and first‐pass hepatic metabolism >99% and 60%, respectively. Secondary analyses of urine cortisol/creatinine excretion found no effects of ciclesonide pMDI between 40 and 320 μg/day or of beclomethasone dipropionate pMDI between 80 and 400 μg/day. Ciclesonide pMDI 40, 80 and 160 μg/day caused no effects on short‐term lower leg growth rate as assessed by knemometry. Ciclesonide 320 μg/day was associated with a numerically short‐term growth suppression equivalent to 30% which was similar to 25% and 36% suppression caused by beclomethasone dipropionate HFA and CFC 200 μg/day, respectively. Consistent with the differences in key pharmacokinetic features, beclomethasone dipropionate is associated with a systemic activity detected by knemometry at a lower dose than ciclesonide. Whether that correlates with a clinically important difference remains to be explored. Assessments of systemic activity of beclomethasone dipropionate <200 μg/day and of ciclesonide >180 μg/day as well as head‐to‐head comparisons are warranted. Preferably, such studies should apply the sensitive method of knemometry. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatric Allergy and Immunology Wiley

Extra‐fine particle inhaled corticosteroids, pharma‐cokinetics and systemic activity in children with asthma

Wolthers, Ole D.
Pediatric Allergy and Immunology , Volume 27 (1) – Feb 1, 2016
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References (81)

Publisher
Wiley
Copyright
Copyright © 2016 John Wiley & Sons A/S
ISSN
0905-6157
eISSN
1399-3038
DOI
10.1111/pai.12491
pmid
26360937
Publisher site
See Article on Publisher Site

Abstract

During recent years, extra‐fine particle inhaled corticosteroids with a median aerodynamic diameter ≤2 μm have been introduced in the treatment of asthma. The aim of this paper was to review pharmacokinetics and systemic activity of extra‐fine particle hydroalkane pressurized metered dose inhaled (pMDI) ciclesonide and beclomethasone dipropionate in children. A literature review was performed. Systemic bioavailability of oral and pulmonary deposition of extra‐fine ciclesonide and beclomethasone dipropionate was 52% and 82%, the half‐life in serum 3.2 and 1.5 h and first‐pass hepatic metabolism >99% and 60%, respectively. Secondary analyses of urine cortisol/creatinine excretion found no effects of ciclesonide pMDI between 40 and 320 μg/day or of beclomethasone dipropionate pMDI between 80 and 400 μg/day. Ciclesonide pMDI 40, 80 and 160 μg/day caused no effects on short‐term lower leg growth rate as assessed by knemometry. Ciclesonide 320 μg/day was associated with a numerically short‐term growth suppression equivalent to 30% which was similar to 25% and 36% suppression caused by beclomethasone dipropionate HFA and CFC 200 μg/day, respectively. Consistent with the differences in key pharmacokinetic features, beclomethasone dipropionate is associated with a systemic activity detected by knemometry at a lower dose than ciclesonide. Whether that correlates with a clinically important difference remains to be explored. Assessments of systemic activity of beclomethasone dipropionate <200 μg/day and of ciclesonide >180 μg/day as well as head‐to‐head comparisons are warranted. Preferably, such studies should apply the sensitive method of knemometry.

Journal

Pediatric Allergy and Immunology – Wiley

Published: Feb 1, 2016

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