A SINGLE daily preventer dose of inhaled corticosteroid (beclomethasone), taken mid-afternoon, may be the best time for effective asthma control, researchers have found.
The mid-afternoon dose suppressed the usual nighttime worsening of symptoms more effectively than a morning dose or the standard protocol of two smaller doses morning and evening.
Aligning the timing of drug treatment with the body clock, known as chronotherapy, can enhance the therapeutic effects of medicines, said the researchers.
This may be particularly important in asthma, which has a distinct daily rhythm, with the effects of airflow obstruction and airway inflammation peaking overnight, which is when 80% of fatal asthma attacks occur.
As glucocorticoid sensitivity is enhanced in the afternoon, this may be the ideal time to take it.
The study involved 25 people with mild-to-moderate asthma, and the dosage regimens were 400 g beclomethasone at around 8am, 400 g beclomethasone at around 4pm, or 200 g beclomethasone at 8am and 8pm.
Airway inflammation and nighttime lung function were improved in all dosing regimens, but more so with the afternoon dose.
While the differences were small, benefits may be more apparent in a larger sample size or for people with severe asthma.
If the findings are confirmed in larger studies, this approach may lead to better clinical outcomes for patients without increasing unwanted steroidal side effects or medical costs, the researchers said.
The paper is available HERE. KB
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