Use of mometasone furoate administered via a dry powder inhaler in the treatment of asthma

Abstract

Background:

Inhaled corticosteroids (ICSs) are effective controller medications that treat the chronic inflammation of asthma. The goal of asthma treatment is to improve lung function, symptoms, and the ability to perform daily activities, while decreasing the risk of exacerbations. Mometasone furoate delivered via a dry powder inhaler (MF-DPI) is indicated for once-daily maintenance treatment of asthma in patients as young as 4 years old.

Objective:

To review the quality of evidence for the clinical efficacy and safety of MF-DPI in both adults and children in the context of grading systems for guideline recommendations. Publications were identified by searching PubMed (MEDLINE) for ‘mometasone furoate AND dry powder inhaler AND asthma’ in any field with search limits for publications from 1 January 1995 to 1 August 2008.

Findings:

MF-DPI has been evaluated in 21 randomized, double-blind, active- or placebo-controlled trials in adults with asthma. Clinical trials investigating the efficacy in patients previously treated with only short-acting β₂-agonists, other ICSs, or oral corticosteroids revealed that MF-DPI is efficacious in these populations. The results of a pooled analysis of ten trials and individual results of three long-term safety trials indicate that MF-DPI is well-tolerated with minimal adverse events. Six clinical trials of MF-DPI have been completed in children. Studies of pediatric patients treated with approved doses of MF-DPI indicate that children previously maintained on twice-daily treatment of other ICSs showed improvements in lung function, health-related quality of life, and rescue medication use. In addition, there is no effect on growth velocity or the hypothalamic–pituitary–adrenal axis. In both adults and children, once-daily dosing of MF-DPI has been demonstrated to be as efficacious as twice-daily dosing.

Conclusion:

The findings of this single-database review are that once-daily MF-DPI is efficacious and safe in both adults and children with asthma.

Key words::

• Asthma
• Dry powder inhaler
• Inhaled corticosteroids
• Mometasone furoate
• Once daily

Transparency

Declaration of funding

Support for medical writing/editorial assistance on this manuscript was funded by Schering-Plough Corporation, now Merck & Co., Inc., Whitehouse Station, NJ, U.S.A. (manufacturers of a proprietary mometasone furoate dry powder inhaler).

Declaration of financial/other relationships

M.Z. has disclosed that he has no relevant financial relationships. J.C. has disclosed serving as a consultant with AstraZeneca, GlaxoSmithKline, Schering-Plough and Amgen; participating in speaker’s bureaus for AstraZeneca, GlaxoSmithKline, Schering-Plough and Sepracor; and receiving grants for research from AstraZeneca, GlaxoSmithKline, Schering-Plough, Amgen, Sepracor, Abbott, and SkyPharma. D.T. has disclosed acting as a consultant for and receiving research funding from Schering-Plough; acting as a member of the advisory board and speaker program for AstraZeneca; and receiving grant support from AstraZeneca and GlaxoSmithKline. Peer reviewers may receive honoraria for their review work with CMRO. The peer reviewers have disclosed no relevant financial relationships.

Acknowledgments

Medical writing and/or editorial assistance was provided by Erin Scott, PhD at Complete Publication Solutions, LLC (with funding support from Schering-Plough, now Merck & Co., Inc.)

Notes

*Asmanex Twisthaler is a registered trade name of Merck & Co., Inc., Whitehouse Station, NJ, USA.