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Author: Admin | 2025-04-28
And meta-analysis of randomized controlled trials compared the inhalation of two doses of the same ICS in steroid-naive adults with asthma (12). Efficacy comparisons were presented between “high” (≥800 μg/d beclomethasone propionate chlorofluorocarbon propellant [BDP CFC] or equivalent) and “moderate” (400 μg/d BDP CFC or equivalent), between “moderate” and “low” (≤200 μg/d BDP CFC or equivalent), and between “high then step-down” and a constant “moderate/low” dose. There were no statistically or clinically significant differences in lung function or symptoms between “high” and “moderate” doses of ICS or between the “high then step-down” versus “moderate/low” doses of ICS. There were statistically but not clinically significant improvements in lung function and symptoms with moderate versus low doses of ICS. No standardized data on severe exacerbations were presented. As a result, the top of the dose–response curve for therapeutic efficacy with the initiation of ICS is around 400 μg/d BDP (200 μg of FP equivalent), which is currently classified as a low ICS dose.Moderate to Severe AsthmaSection:A series of systematic reviews and meta-analyses has determined the dose–response relationship of therapeutic efficacy of the most commonly used ICS in adolescents and adults with moderate to severe asthma. The most comprehensive data are available from randomized controlled trials of FP (13, 14) and budesonide (15). In randomized placebo-controlled trials of FP in adolescents and adults with asthma, 80% of the benefit obtained at 1,000 μg/d was achieved at doses of 70–180 μg/d and 90% at a dose of 100–250 μg/d (Figure 1 and Table 2).
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