A Smart + Strong Site
Subscribe to:
E-newsletters
POZ magazine
JOIN AIDSMEDS YouTube

Back to home » Treatment News » Top Stories

Most Popular Stories
An Almost Normal Life Expectancy for People With HIV?
Undetectable Viral Load Essentially Eliminates Transmission Risk in Straight Couples
A 15-Year Jump in Life Expectancy for People With HIV
Misleading News Reports Suggest HIV Cure Is Near
New HIV Drug Class Shows Promise
Gene Therapy Shows Promise in Controlling HIV
Potential Microbicide Tricks HIV Into Sudden Death
What's That Mean?
(just double-click it!)

If you don't understand one of the words in this article, just double-click it. A window will open with a definition from mondofacto's On-line Medical Dictionary. If the double-click feature doesn't work in your browser, you can enter the word below:

Most Popular Lessons
Aging & HIV
The HIV Life Cycle
Shingles
Herpes Simplex Virus
Syphilis & Neurosyphilis
Treatments for Opportunistic Infections (OIs)
What is AIDS & HIV?
More News

Have medical or treatment news about HIV? Send press releases, news tips and other announcements to news@aidsmeds.com.

Click here for more news


emailprint

March 15, 2012

Inhaled Beclomethasone Bests Fluticasone (Advair) When HIV PIs Being Used

by Tim Horn

CROI 2012 CROI 2012Good news for people living with HIV and asthma, bronchitis and chronic obstructive pulmonary disease (COPD). The inhalable steroid beclomethasone can be used at the same time as HIV protease inhibitors without the increased risk of adrenal suppression, according to a drug interaction study conducted in HIV-negative volunteers reported Thursday, March 8, at the 19th Conference on Retroviruses and Opportunistic Infections in Seattle. 

As explained by U.S. Food and Drug Administration (FDA) and National Institutes of Health (NIH) investigators who reported the data, people living with HIV and respiratory disease often require protease inhibitors and orally inhaled corticosteroids. Inhaled corticosteroids alone do not generally cause serious side effects because very little of the medication passes into the bloodstream. However, the combination of various protease inhibitors and inhaled fluticasone—one of the active ingredients in the popular Advair diskus and the intranasal product Flonase—has led to increased systemic fluticasone levels and multiple cases of adrenal gland insufficiency and Cushing’s syndrome (an overabundance of corticosteroids in the blood, leading to symptoms such as a fatty hump between the shoulders, a rounded “moon face,” high blood pressure, bone loss and possibly diabetes).

Beclomethasone, inhaled as either Qvar or Clenil or used intranasally as Beconase, has been considered a safe alternative. Though it is metabolized by the same enzyme system (CYP3A4) as fluticasone, it undergoes other important chemical breakdowns in the body, with only trace amounts of the steroid detectable in blood samples. These observations, the authors report, “suggest that systemic accumulation leading to significant adverse effects is unlikely even in the presence of a CYP3A4 inhibitor such as an HIV protease inhibitor.” 

To determine whether or not beclomethasone has a discernible effect on the function of the adrenal glands—located above the kidneys and the producer of steroid hormones, notably cortisol, responsible for regulating sodium, potassium and water retention—the researchers treated 30 HIV-negative volunteers with twice-daily puffs of 160 microgram doses of the corticosteroid for 14 days. For the next three weeks, 10 patients were randomized to continue taking inhaled beclomethasone alone, 10 were allotted to combine beclomethasone with oral doses of Norvir (ritonavir), and the remaining 10 were assigned to a group combining beclomethasone with Norvir (ritonavir) plus Prezista (darunavir). 

All study volunteers underwent a series of adrenocorticotropic hormone (ACTH) stimulation tests to measure peak cortisol levels. The test is frequently used to diagnose or exclude adrenal insufficiency. 

There were no statistically significant reductions in daily basal (lowest) or peak (highest) cortisol levels at any time point—after 14 days of inhaled beclomethasone alone or both during and after the randomized part of the trial—and there were no significant difference between the three groups.

“Combined use of orally inhaled beclomethasone and [Norvir or Norvir-boosted Prezista] for 28 days does not cause significant adrenal suppression in HIV-negative healthy volunteers,” the authors conclude. “Inhaled beclomethasone is preferable to inhaled fluticasone for treatment of HIV-infected patients receiving [protease inhibitors].”

Search: beclomethasone, qvar, clenil, fluticasone, advair, flonase, asthma, copd, pulmonary, interactions, protease inhibitors, norvir, ritonavir, prezista, darunavir, fda, nih, boyd, croi, seattle


Scroll down to comment on this story.



Name:

(will display; 2-50 characters)

Email:

(will NOT display)

City:

(will display; optional)

Comment (500 characters left):

(Note: The AIDSmeds team reviews all comments before they are posted. Please do not include ":" "@" "<" ">" in your comment. The opinions expressed by people providing comments are theirs alone. They do not necessarily reflect the opinions of Smart + Strong, which is not responsible for the accuracy of any of the information supplied by people providing comments.)

Comments require captcha.
Please enter this number for verification:

| Posting Rules



Show comments (0 total)


[Go to top]

Quick Links
AIDSmeds en Español
About HIV and AIDS
Lab Tests
Clinical Trials
HIV Meds
Starting Treatment
Switching Treatment
Drug Resistance
Side Effects
Disclosure
Lipodystrophy
Hepatitis & HIV
Women & Children
Fact Sheets
Treatment News
Community Forums
Blogs
Conference Coverage
Health Services Directory
POZ Magazine


    adoniz89
    san dimas
    California


    InDefaultOf
    Seattle
    Washington


    pevans
    San Francisco
    California


    daino1972
    Columbus
    Ohio
Click here to join POZ Personals!
Conference Coverage

21st Conference on Retroviruses and Opportunistic Infections
(CROI 2014)
Boston, MA
March 3 - 7, 2014


7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention
(IAS 2013)
Kuala Lumpur, Malaysia
June 30 - July 3, 2013


20th Conference on Retroviruses and Opportunistic Infections
(CROI 2013)
Atlanta, GA
March 3 - 7, 2013


more conference coverage

[ about AIDSmeds | AIDSmeds advisory board | our staff | advertising policy | advertise/contact us]
© 2014 Smart + Strong. All Rights Reserved. Terms of use and Your privacy.
Smart + Strong® is a registered trademark of CDM Publishing, LLC.