Cystic fibrosis (CF) is a progressive, genetic disease that results in the overproduction of thick, sticky mucus in multiple parts of the body. In the lungs, this mucus can lead to chronic inflammation and become a breeding ground for microbes.
Beclomethasone is an inhaled steroid used to prevent inflammation in the airways. It helps reduce the immune response to irritants with the hope of reducing the swelling and scarring that can occur in CF.
Beclomethasone is available in the U.S. under the brand names Qvar and QNASL produced by Teva Pharmaceuticals and Beconase AQ produced by GlaxoSmithKline. The treatment was previously sold under the other brand names Vancenase, Vanceril, Beclovent, and Beconase, but these have all been discontinued.
Beclomethasone is approved for use in patients, ages 4 and older, to prevent asthma attacks (Qvar) and seasonal allergy symptoms (Beconase AQ and QNASL). Beclomethasone is not currently approved for the treatment of CF, but the Stanford CF Center has recommended its use to help with chest congestion and inflammation.
How beclomethasone works
Beclomethasone is a corticosteroid, which can be used to reduce swelling and inflammation in the airways to make breathing easier. It is most often taken as a powder that is breathed in through an inhaler, but in young children, it can be given as a liquid in a nebulizer. The steroid is often prescribed to be inhaled two to four times a day to help reduce inflammation.
Beclomethasone in clinical trials
Beclomethasone has been tested in a few studies for CF.
An early study in 26 patients with chronic Pseudomonas aeruginosa infections, which are very common in CF patients, showed no differences in inflammatory response between the 13 patients treated with beclomethasone and the remaining 13 patients given placebo after 16 weeks.
In another study, 25 patients were treated with beclomethasone and 24 were given placebo for 30 days. There were again no differences found between the two groups in forced vital capacity (the amount of air that can be forcibly exhaled), forced expiratory volume in one second (the amount of air that can be exhaled in one second in a forced expiration), and airway resistance (the amount of pressure needed to produce airflow). However, the study saw improvements in thoracic gas volume (the amount of air the lungs can hold) and diffusion capacity of carbon monoxide (the efficacy of gas transfer between the lungs and blood).
Two studies that reviewed all of the beclomethasone and CF studies were not able to find sufficient evidence of the benefits of inhaled steroid use including beclomethasone. It is possible that inhaled steroids such as beclomethasone do not provide any benefits or that the studies were not sufficiently large or long enough to show any benefit.
As with any medication, beclomethasone can cause side effects. Less severe side effects include cough, nausea, headache, sore throat, hoarseness, runny or stuffy nose, and pain in the back.
Beclomethasone can also cause more severe side effects including delayed growth in children as well as fungal infection of the mouth and throat, reduced adrenal function, immune system problems, allergic reactions, lower bone density, and eye problems.
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