Once-daily evening administration of mometasone furoate in asthma treatment initiation

Background: In a previous study, a 200-mu g once-daily evening dose of mometasone furoate dry powder inhaler (DPI) was effective in patients with asthma previously taking inhaled corticosteroids. No studies have been conducted to test the effect of a once-daily evening dose in patients previously using only short-acting beta(2)-adrenergic agonists (SABAs) for symptom relief. Objective: To evaluate the effectiveness of mometasone furoate DPI administered once daily in the evening as initial controller therapy in patients previously using SABAs alone for asthma. Methods: Patients with mild-to-moderate persistent asthma from 18 US centers participated in a 12-week, randomized, double-blind, placebo-controlled study. Patients received either mometasone furoate DPI, 200 mu g, or placebo once daily in the evening. The primary efficacy variable was the change in forced expiratory volume in I second from baseline to the end point (last evaluable visit). Other measurements included forced vital capacity, forced expiratory flow between 25% and 75%, morning and evening peak expiratory flow, asthma symptoms, use of albuterol, nocturnal awakenings, physicians' evaluation of response to therapy, and time to asthma worsening. Results: At the end point, the mean increase in forced expiratory volume in I second relative to baseline for the mometasone furoate DPI group of 0.43 L (16.8%) was significantly greater than that for the placebo group of 0.16 L (6.0%) (P < .01). Morning peak expiratory flow, forced vital capacity, and forced expiratory flow between 25% and 75% also significantly improved with mometasone furoate DPI treatment relative to placebo (P < .01). Once-daily dosing with mometasonefuroate DPI was well tolerated. Conclusion: Mometasone furoate DPI (200 mu g) administered once daily in the evening significantly improves pulmonary function in patients previously using SABAs alone for asthma control.