QVAR (beclomethasone dipropionate HFA) Inhalation Aerosol

ASTHMA CONTROL FOR
LARGE AND SMALL AIRWAYS

Small Airways Are Important Sites of Inflammation

The small airways in the lungs can be sites of chronic inflammation in patients with asthma.1 As a result, the airways can undergo irreversible structural changes.2 Treating inflammation in the small airways may improve lung function,1 contribute to asthma control,1,3 and reduce the severity of asthma attacks in response to triggers.3 Large-particle ICS formulations are less likely to reach and treat both the large and small airways, where underlying chronic inflammation may persist.4,5

Inflamed vs. non-inflamed small airways

QVAR® is a small-particle inhaled corticosteroid (ICS) that can help patients with mild to moderate persistent asthma control their symptoms.6 The mean particle size of QVAR® is 1.1 µm—smaller than that of most other ICSs—meaning that QVAR® distributes evenly throughout the large and small airways.1,7-8*

Particle Size
Lung Deposition vs Competition

QVAR® (beclomethasone dipropionate HFA) Inhalation Aerosol is indicated in the maintenance treatment of asthma as prophylactic therapy in patients 5 years of age or older. QVAR® is also indicated for asthma patients who require systemic corticosteroid administration, where adding QVAR® may reduce or eliminate the need for systemic corticosteroids.

Important Safety Information

  • QVAR® is not a bronchodilator and is not indicated for relief of acute bronchospasm
  • Common side effects associated with the use of QVAR® and placebo in clinical trials include, but are not limited to, headache (12% and 9%, respectively) and pharyngitis (8% and 4%, respectively)
CAUTION: Adrenal insufficiency may occur when transferring patients from systemic steroids (see WARNINGS, Prescribing Information).
  • A reduction in growth velocity in growing children and teenagers may occur as a result of inadequate control of chronic diseases such as asthma or from use of corticosteroids for treatment

* The relationship of better lung deposition and particle size to clinical efficacy is unknown.

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References

  1. Martin RJ. Therapeutic significance of distal airway inflammation in asthma. J Allergy Clin Immunology. 2002; 109(2):S447-S460.
  2. Hyde DM, Hamid Q, Irvin CG. Anatomy, pathology, and physiology of the tracheobronchial tree: emphasis on the distal airways. J Allergy Clin Immunol. 2009;124(6 Suppl):S72-77.
  3. NHLBI Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed April 20, 2010.
  4. Leach CL, Davidson PJ, Hasselquist BE, Boudreau RJ. Lung deposition of hydrofluoroalkane-134a beclomethasone is greater than that of chlorofluorocarbon fluticasone and chlorofluorocarbon beclomethasone: a cross-over study in healthy volunteers. Chest. 2002;122:510-516.
  5. Gelfand EW, Kraft M. The importance and features of the distal airways in children and adults. J Allergy Clin Immunol. 2009 Dec;124(6 Suppl):S84-7.
  6. QVAR® (beclomethasone dipropionate HFA) Prescribing Information. Teva Respiratory, LLC; 2010.
  7. Leach CL. Effect of formulation parameters on hydrofluoroalkane-beclomethasone dipropionate drug deposition in humans. J Allergy Clin Immunol. 1999;104:S250-S252.
  8. Leach C, Colice GL, Luskin A. Particle size of inhaled corticosteroids: does it matter? J Allergy Clin Immunol. 2009;124:S88-S93.
  9. Mauad T, Silva LFF, Santos MA, et al. Abnormal alveolar attachments with decreased elastic fiber content in distal lung in fatal asthma. Am J Respir Crit Care Med. 2004;170(8):857-862.
  10. Warren S, Taylor T, Smith J, Buck H, Parry-Billings M. Gamma scintigraphic evaluation of a novel budesonide dry powder inhaler using a validated radiolabeling technique. J Aerosol Med. 2002;15(1):15-25.
  11. Cripps A, Riebe M, Schulze M, Woodhouse R. Pharmaceutical transition to non-CFC pressurized metered dose inhalers. Respir Med. 2000;94(suppl B):S3-S9.
  12. Data on file. Teva Respiratory, LLC; 2009.
  13. Data on file. Teva Respiratory, LLC; 2010.
  14. Rohatagi S, Derendorf H, Zech K, Nave R, Banerji D. PK/PD of inhaled corticosteroids: the risk/benefi t of inhaled ciclesonide [abstract]. J Allergy Clin Immunol. 2003;111(suppl 2): S218.
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