A Comparative Study on the Efficacy of inhaler Formulation of Fluticasone Propionate with Budesonide and Beclomethasone Dipropionate in Chronic Obstructive Pulmonary Disease
INTRODUCTION: Chronic obstructive pulmonary disease (COPD)[4] is a respiratory disease
characterized by chronic airway inflammation, a decline in lung function over time,
and progressive impairment in quality of life. The disease has relatively high
prevalence rates worldwide (5–13%) and is mainly caused not only by the inhalation
of noxious substances, predominantly cigarette smoking in the Western world, but
also by indoor air pollution, particularly in the developing countries. COPD is
associated with high mortality and morbidity rates and a high economic and social
burden, mainly due to the requirement for substantial and ongoing medical support.
COPD is the fourth leading cause of death worldwide and is expected to be the third
leading cause by 2030. It is generally believed that despite the availability of both
national and international guidelines, COPD remains substantially underdiagnosed
and undertreated and is rarely regarded as a health issue of top priority.
For many years, smoking cessation has been known to be the single effective
intervention for reducing the risk of developing COPD and slowing its progression
down .However, recent data from long-term trials have shown that initiating
maintenance pharmacological treatment at early stages of the disease, when there is
an opportunity to alter the progression of the disease and maximize patient benefit,
may alter the clinical course of COPD and can be more effective than at later stages of
the disease . Moreover, it has been demonstrated that despite the relative steroid
insensitivity of airway inflammation in COPD, the combination of long-acting
bronchodilator therapy with inhaled glucocorticosteroids (ICS)is beneficial for
patients with severe COPD . Thus, early and optimal pharmacotherapy appears to be
fundamental in the management of COPD. AIM OF THE STUDY: The aim of the study is to compare the efficacy and adverse effects of
fluticasone propionate with that of budesonide and beclomethasone dipropionate in
COPD patients. OBJECTIVE OF THE STUDY: This study is designed to Evaluate the efficacy of fluticasone propionate with that
of budesonide and beclomethasone dipropionate in improving lung function,
decreasing symptoms and need for rescue medication in COPD
A) To establish the effectiveness patient counselling
B) To statistically analyze the variables in order to find out the significance DISCUSSION: This study I compares the efficacy of prescribed doses of inhalational steroids
in COPD Patients with Fluticasone propionate 100μg twice daily, Budesonide 200 μg
twice daily, Beclomethasone dipropionate 200 μg twice daily for four month period .
In the present study, the demographic characteristics of the subjects were
collected. Out of the 60 COPD patients collected 60% were male and 40% were
females. During the study it was observed that most of the populations were from the
urban area (60%) are affected as compared to rural area (40%) and this is due to
certain aggravating factors like allergens, Dust, air pollution and climatic change. It
was observed that 45% of patients coming to the clinic with COPD were between the
age group 35-65 years of age when compare to other age groups. Patients in the age
group of 46 to 50 are increasing number in this treatment.
Out of the 60 patients 36 (60%) were males and 24(40%) were females. This
shows that male patients were mostly affected by disorders than female patients. Out
of the 60 patients 36 (60%) were from Urban area and 24(40%) were from Rural
area . This shows that Urban patients were mostly affected by disorders than Rural
patients due to pollution and other environmental factors.
In commonly, 30% of Patients know physical illness as the Cause for COPD,
70% of patients Don’t know about physical illness as the Cause for COPD problems
In commonly, 30% of Patients know about prevention for COPD eg: Smoking
cessation, Improving quality, Occupational therapy, Influenza vaccinations,
Pneumococcal vaccination, 70% of patients Don’t know about Cause Prevention for
COPD.
Out of 60 patients, 20 (33%) were in treatment with Fluticasone Inhalation.
Patients showed improvement in COPD with mean value of 26.08%. CONCLUSION: The observational analysis and the laboratory parameters were showed
significant improvements in Fluticasone propionate treatment than budesonide and
beclomethasone dipropionate. It can be concluded that fluticasone propionate is
superior to budesonide and beclomethasone dipropionate in improving lung function,
decreasing symptoms and need for rescue medication in COPD. Patient compliance
was good with all the three drugs and there is no adverse effect. All the three drugs
are well tolerated at doses used in this study