QVAR® (beclomethasone dipropionate HFA) Asthma Control Inhaler

INITIATING ASTHMA
CONTROL THERAPY

Asthma Control Using ICS Treatment Alone

Using patients registered in the UK's General Practice Research Database (GPRD), a 1-year, real-world, observational, retrospective, matched-cohort analysis of asthma control with QVAR® was conducted.1 This study found that:

  • 86% of patients initiated on QVAR® achieved asthma control
  • 92% of patients initiated on QVAR® had no asthma exacerbations during the course of the study

Asthma control was defined as: no recorded hospital attendance for asthma; no prescription for oral corticosteroid; and no consultation, hospital admission, or emergency department attendance for lower respiratory tract infection requiring antibiotics.

Match Asthma Medication to Symptom Severity

In order to achieve and maintain asthma control, NHLBI guidelines for the treatment of asthma generally recommend a stepwise approach, which may include the following:2

  • Initiating therapy for mild to moderate persistent asthma with a low- to medium-dose ICS.
  • Stepping up ICS dose if necessary.
  • Gradually reducing medication if asthma is well controlled for at least 3 months.
  • Identifying the minimum therapy required for maintaining control of asthma symptoms.
Stepwise approach for managing asthma in youths older than 12 and adults

FDA Guidelines on the Use of LABAs and ICS/LABA Combination Products

When used as monotherapy for the treatment of asthma, LABAs are associated with an increased risk of severe exacerbation of asthma symptoms, which may lead to hospitalizations or death in some patients.3 Currently available data are inadequate to determine whether ICSs mitigate the increased risk of asthma-related death from LABAs.2 Given the benefits and well known safety profiles of ICSs in patients with asthma, the FDA believes that it is prudent to:4

  • Emphasize the use of ICSs
  • Limit the long-term use of LABAs with or without ICS

ICSs such as QVAR® are considered first-line controller therapy for mild to moderate persistent asthma by the FDA. ICS/LABA combination products are recommended for use only when disease severity clearly warrants treatment with both an ICS and a LABA.3

An analysis of claims data has suggested that combination therapy may be overused: 69% of adult patients who had mild persistent asthma and were prescribed an ICS/LABA combination had not filled a single-entity ICS prescription during the previous year.5

Indication

QVAR® (beclomethasone dipropionate HFA) Inhalation Aerosol is indicated in the maintenance treatment of asthma as prophylactic therapy in patients 5 years of age or older. QVAR® is also indicated for asthma patients who require systemic corticosteroid administration, where adding QVAR® may reduce or eliminate the need for systemic corticosteroids.

Important Safety Information

QVAR® is not a bronchodilator and is not indicated for relief of acute bronchospasm.

CAUTION: Adrenal insufficiency may occur when transferring patients from systemic steroids (see WARNINGS, Prescribing Information).

A reduction in growth velocity in growing children and teenagers may occur as a result of inadequate control of chronic diseases such as asthma or from use of corticosteroids for treatment

Common side effects associated with the use of QVAR® and placebo in clinical trials include, but are not limited to, headache (12% and 9% respectively) and pharyngitis (8% and 4% respectively).

References

  1. Price D, Martin RJ, Barnes N, et al. Prescribing practices and asthma control with hydrofluoroalkane-beclomethasone and fluticasone: a real-world observational study. J Allergy Clin Immunol. 2010;126(3): 511-518.
  2. NHLBI Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed April 20, 2010.
  3. Center for Drug Evaluation and Research. FDA Drug Safety Communication: Drug labels now contain updated recommendations on the appropriate use of long-acting inhaled asthma medications called Long-Acting Beta-Agonists (LABAs). Available at: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm213836.htm [Accessed July 7, 2010].
  4. Chowdhury BA. Long-acting beta-agonists safety trials. Presentation at: FDA Advisory Committee Meeting; March 10-11, 2010; Silver Spring, MD.
  5. Friedman H, Wilcox T, Reardon G, Crespi S, Yawn BP. A retrospective study of the use of fluticasone propionate/salmeterol combination as initial asthma controller therapy in a commercially insured population. Clin Ther. 2008;30(10):1908-1917.
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