Anti‐inflammatory effects of once daily low dose inhaled ciclesonide in mild to moderate asthmatic patients

Background: Ciclesonide exhibits clinical efficacy at 160 μg (ex‐actuator) once daily but the anti‐inflammatory effects at this dose are not known. We wished to know whether 4 weeks therapy with ciclesonide pMDI 160 μg once daily in the morning exhibited significant anti‐inflammatory effects.Methods: Seventeen patients with mild persistent asthma (FEV1 3.35 l) were recruited into a double‐blind placebo‐controlled randomized crossover study. Measurements were made after ciclesonide and placebo treatment as well as after run‐in and washout periods, for adenosine monophosphate (AMP) bronchial challenge (primary variable), exhaled nitric oxide (NO) and induced sputum (in a subgroup).Results: The mean (SEM) AMP bronchial challenge PC20 following ciclesonide (140 (63) mg/ml) was significantly (P < 0.001) increased compared with placebo (17 (8) mg/ml), run‐in (13 (5) mg/ml) and washout (9 (3) mg/ml) periods. This amounted to an eightfold (CI: 5.3–12.0) for ciclesonide vs placebo. Likewise, there were significant improvements in exhaled NO levels and a significant reduction in induced sputum eosinophil cell counts.Conclusion: We have shown that inhaled ciclesonide given at 160 μg once daily in the morning exhibits significant anti‐inflammatory effects that are in keeping with the previously described clinical effects.

Anti‐inflammatory effects of once daily low dose inhaled ciclesonide in mild to moderate asthmatic patients Journal Articles