Inhaled budesonide may be less potent than beclomethasone in primary care

Inhaled budesonide may be less potent than beclomethasone in primary care

Asthma treatment guidelines internationally regard inhaled budesonide and beclomethasone as equipotent on the basis of randomisedtrials which have usually shown no difference. Randomised clinicaltrials to compare potency are, however, inherently difficult todesign. Rather than assessing efficacy in response to fixed dosesof corticosteroids, Pethica et al on p 986 analysed the dailyprescribed doses for 5930 patients in primary care in New Zealand.In this setting doses are usually adjusted according to the clinicalresponse. Mean beclomethasone doses were significantly lower thanthose for budesonide, and the difference could not be attributedto severity of asthma. The authors conclude that inhaled budesonideis less potent than beclomethasone in primarycare.

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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]