Step-Down" Approach May Be Unnecessary

High-dose fluticasone versus low-doseflucticasone is no more effective in treatingasthma. A study, reported in Chest (January2005), found that starting individualswith moderate asthma on a high dose ofthe inhaled steroid and then steppingdown to a low dose provides no greaterbenefit than starting at a low fixed dose.

For the study, the researchers randomlyassigned 35 patients to begin inhaledfluticasone propionate at 1000 mcg perday and then to lower the dose to 200mcg per day, or to start treatment at afixed dose of 200 mcg.

The results of the study showed thatboth regimens lowered bronchial hyperresponsivenessand airway inflammation toa similar degree. Furthermore, 8 weeksafter stopping fluticasone, inflammationindicators stayed in the normal range in30% of the patients in both groups.