Comparable efficacy of ciclesonide once daily versus fluticasone propionate twice daily in asthma

Background: Inhaled corticosteroids are the mainstay of therapy in asthma, but local and systemic side effects and adherence remain a concern. Ciclesonide is an inhaled corticosteroid with on-site lung activation that provides potent anti-inflammatory activity and has been shown to have a good safety profile, even at high doses. Objective: The aim of this study was to compare the efficacy and safety of once-daily ciclesonide versus twice-daily fluticasone propionate at comparable daily doses in patients with asthma. Methods: In this multicenter, randomized, double-blind, double-dummy, parallel group study, 529 patients were randomized to ciclesonide 160 μg once daily or fluticasone propionate 88 μg twice daily for 12 weeks. The primary endpoint was change in lung function. Results: Both ciclesonide and fluticasone propionate significantly improved forced expiratory volume in 1 s, forced vital capacity, and morning peak expiratory flow compared with baseline (p < 0.0001 for all variables). Both medications reduced asthma symptoms and rescue medication use within the first 24 h. At the tested dose, both medications were equally safe and well tolerated. Conclusion: Ciclesonide 160 μg once daily was as effective as fluticasone propionate 88 μg twice daily in improving lung function and asthma symptoms, and in reducing rescue medication use in patients with asthma. © 2005 Elsevier Ltd. All rights reserved.