High-dose beclomethasone inhaler in the treatment of asthma.

The effects of long-term use of high-dose inhaled beclomethasone dipropionate (BDP) were studied retrospectively in 293 asthmatic patients who were not adequately controlled on conventional doses of BDP or who required oral corticosteroids to control their asthma. The higher doses of BDP were administered in a high-dose beclomethasone aerosol (BDP 250) containing 250 micrograms BDP per metered dose. 27% of the steroid-dependent asthmatics were able to stop oral steroids altogether after the introduction of BDP 250, and a further 39% were able to reduce their daily dosage. Improvement in asthma control was achieved in 62% of all patients and was accompanied by a reduction in the number of severe acute exacerbations and a significant increase in mean peak expiratory flow rate. Oropharyngeal candidiasis was not significantly more common with the BDP 250 inhaler than with conventional inhalers and appears to have been related to the number and frequency of inhalations and not solely to the total dosage. Other side-effects were very rare.