Does middle dose ICS HFA-MDI mixed combination cause any effect on clinical, functional and inflammatory indices among controlled asthma patients using equivalent dose DPI preparations ( Three weeks observational study)

The aim of asthma treatment is to ensure the full control. However, full control may not meanfull control on airway inflammation. Inhibition of the inflammation may change the prognosisby effecting the development of remodeling. The aim of our study is to evaluate whether theuse of HFA Beclametazone/Formoterol 100/6 ?g MDI (Group3) has an additional effect onclinical, functional and inflammatory markers in asthmatic cases under full control accordingto GINA using Budesonide /Formoterol 320/9 ?g DPI (Group 1), Fluticazone /Salmeterol500/50 ?g DPI (Group 2).15 men, 80 women 95 patients in total with mean age 42,6 ± 12,3 were included in our study.The mean period of being an asthma patient was 10,7±8,5 years. Group 3 was constitutedaccidentally from Group 1 and 2 cases. All cases were followed for three weeks. No clinicalor functional difference was determined among the three groups (p>0,05). When the values atthe beginning of the treatment (pre) and at the end of week three (post) were assessed,significant increase were found in Group 1: FEV1% estimated, FEV1/FVC, PEF% estimated,FEF25, FEF50, FEF50%estimated, FEF75, FEF25-75, FEF25-75%estimated, Group 2: FVC;Group 3: FEV1%estimated, FVC%estimated, FEF50, FEF50%estimated parameters(p<0.05). Significant decrease was determined in NO level of expiratory air in Group 3 .Among the Sacin and Scond (pre) and (post) values which were determined by multibreathwashout test, only Group 3 post treatment values were significantly different when comparedto the mean Sacin values. When evaluated individually for each group, a significant statisticalimprovement was found in Scond values in Group 1 and 3 and in Sacin values in Group 3 ).Consequently, at the end of regular use of three different combined preparations with controlfor three weeks no clinical difference was found. In controlled asthmatic cases regulartreatment can provide additional functional improvement. Functional level can show analteration without clinical differences. However that eNO and Sacin values have shownsignificant improvement at the end of treatment period suggested that the combinedpreparation used with HFA technology may have an additional positive effect on theperipheral airway in the cases underfull control.