Comparison of inhaled beclomethasone and budesonide

BMJ 1999;319:124 ( 10 July )

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Comparison of inhaled beclomethasone and budesonide

Patients do not take prescribed doses

Back titration of inhaled steroids is uncommon in New Zealand

Study was inadequate

Studies of potencies of asthma drugs have methodological limitations

Author's reply

Patients do not take prescribed doses

The first 150 words of the full text of this article appear below.

EDITOR $---$ The conclusions reached by Pethica et al in their paper concerning the relative potency of inhaled beclomethasone andbudesonide are not justified because the authors have not verifiedan important assumption in the paper.¹ They have assumed thatpatients are regularly taking the dose recorded on their prescription;the data presented in their paper suggest that this is most unlikely.The total number of prescriptions issued to 5930 patients wasonly 16 725 (under three a year). Most formulations of inhaledsteroid last 50 days at the usual prescribed dose, so patientstaking regular treatment should have used around seven prescriptionsin the 12 months of thestudy.

Analysis of computerised prescriptions in my practice over the 12 months July 1997 to June 1998 shows a similar pattern: 625patients received 2424 prescriptions for inhaled steroids (aroundfour a year on average). Analysis of individual data on 59 patientsaged 30-35 shows that 36 of the 59 were prescribed fewer . . . [Full text of this article]

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Relevant Article

Comparison of potency of inhaled beclomethasone and budesonide in New Zealand: retrospective study of computerised general practice records: B D Pethica, A Penrose, D MacKenzie, J Hall, R Beasley, and M Tilyard
BMJ 1998 317: 986-990. [Abstract] [Full Text] [PDF]