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Keywords:

  • adenosine 5′-monophosphate;
  • airway hyperresponsiveness;
  • asthma;
  • eNO;
  • fluticasone furoate;
  • fluticasone propionate

To cite this article: van den Berge M, Luijk B, Bareille P, Dallow N, Postma DS, Lammers J-WJ. Prolonged protection of the new inhaled corticosteroid fluticasone furoate against AMP hyperresponsiveness in patients with asthma. Allergy 2010; 65: 1531–1535.

Abstract

Introduction:  Single-dose inhaled corticosteroids (ICS) induce direct anti-inflammatory effects in asthma thereby improving airway hyperresponsiveness (AHR). A novel enhanced-affinity ICS, fluticasone furoate (FF), demonstrated a prolonged duration of action in vitro. The aim of this study was to evaluate the efficacy and duration of action of a single dose of FF by studying protection against AHR to adenosine 5′-monophosphate (AMP) and effects on exhaled nitric oxide (eNO).

Methods:  A randomized, double-blind, placebo-controlled, 6-way crossover study (FFA10026) was performed in 24 patients with allergic asthma (mean age 32.8 years, FEV1 ≥ 70% predicted and PC20 AMP ≤ 50 mg/ml). Each subject received a single dose of FF 1000 μg, fluticasone proprionate (FP) 1000 μg, or placebo at 2 (FF only), 14 or 26 h prior to AMP challenge and eNO measurement.

Results:  FF significantly improved PC20 AMP compared to placebo, the difference in doubling concentrations being 2.18 (95% confidence interval: 1.13–3.23), 1.54 (0.48–2.59), and 1.30 (0.26–2.34) at 2, 14 and 26 h. FP improved PC20 AMP significantly at 14 h compared to placebo, but not at the 26-hour time point, the difference in doubling concentrations being 1.72 (0.70–2.75) and 0.33 (−0.69–1.34). There was no significant effect on eNO after either FF or FP at all time points. FF was well tolerated and there were no serious adverse events.

Conclusion:  The new inhaled corticosteroid FF, but not FP, demonstrates prolonged protection up to 26 h against AHR to AMP in asthma patients.