Randomized trial of inhaled beclomethasone dipropionate versus theophylline for moderate asthma during pregnancy - 25/08/11
, Michael Schatz, MD b, Robert Wise, MD c, Elizabeth A Thom, PhD d, Mark Landon, MD e, William Mabie, MD f, Roger B Newman, MD g, Donald McNellis, MD h, John C Hauth, MD i, Marshall Lindheimer, MD j, Steve N Caritis, MD k, Kenneth J Leveno, MD l, Paul Meis, MD m, Menachem Miodovnik, MD n, Ronald J Wapner, MD o, Michael W Varner, MD p, Mary Jo O'Sullivan, MD q, Deborah L Conway, MD r, for The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, and The National Heart, Lung, and Blood Institute
Reprint requests: Mitchell P. Dombrowski, St John Hospital, Department of Obstetrics and Gynecology, 22151 Moross Rd, Suite 313, Detroit MI 48236. Abstract |
Objective |
This study was undertaken to compare the efficacy of inhaled beclomethasone dipropionate to oral theophylline for the prevention of asthma exacerbation(s) requiring medical intervention.
Study design |
A prospective, double-blind, double placebo-controlled randomized clinical trial of pregnant women with moderate asthma was performed.
Results |
There was no significant difference (P=.554) in the proportion of asthma exacerbations among the 194 women in the beclomethasone cohort (18.0%) versus the 191 in the theophylline cohort (20.4%; risk ratio [RR]=0.9, 95% CI=0.6-1.3). The beclomethasone cohort had significantly lower incidences of discontinuing study medications caused by side effects (RR=0.3, 95% CI=0.1-0.9; P=.016), and proportion of study visits with forced expiratory volume expired in 1 second (FEV1) less than 80% predicted (0.284±0.331 vs 0.284±0.221, P=.039). There were no significant differences in treatment failure, compliance, or proportion of peak expiratory flow rate less than 80% predicted. There were no significant differences in maternal or perinatal outcomes.
Conclusion |
The treatment of moderate asthma with inhaled beclomethasone versus oral theophylline resulted in similar rates of asthma exacerbations and similar obstetric and perinatal outcomes. These results favor the use of inhaled corticosteroids for moderate asthma during pregnancy because of the improved FEV1 and because theophylline had more side effects and requires serum monitoring.
Le texte complet de cet article est disponible en PDF.Keywords : Asthma, Theophylline, Beclomethasone, Pregnancy
Plan
 | Supported by grants from the National Institute of Child Health and Human Development (HD21410, HD21414, HD21434, HD27869, HD27917, HD27905, HD27889, HD27860, HD27861, HD27915, HD27883, HD34122, HD34116, HD34208, HD34136, and HD36801) and the National Heart Lung and Blood Institute. Presented at the Society of Maternal Fetal Medicine 2001 annual meeting, Reno, Nev. |
Vol 190 - N° 3
P. 737-744 - mars 2004 Retour au numéro
Article précédent
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