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Now that inhaled corticosteroids are a mainstay of asthma therapy, prescribed doses have increased progressively -- and not necessarily as a result of scientific analysis. To determine the most effective dose range, New Zealand investigators performed a meta-analysis of randomized placebo-controlled trials in which at least 2 dosages of inhaled fluticasone were evaluated in adolescents and adults with asthma.
Eight studies, with a total of 2324 patients, were identified; 5 of the studies included fluticasone dosages as high as 800 to 1000 μg/day. The dose-response curve began to plateau at 100 to 200 μg/day and peaked at 500 μg/day. According to a mathematical model, 90 percent of possible maximum benefit was achieved at 100 to 250 μg/day, a…