Ciclesonide | place in therapy review Table 7 | Effect on symptoms and use of rescue medications of ciclesonide compared with placebo and active treatment in patients with asthma (level 2 evidence; all trials in adults, randomized) Treatment (mcg) [duration] Placebo-controlled trials Baseline FEV1 (% of predicted) Outcome Symptom-free days (%) Use of rescue medication (puffs/day) Median number of symptom-free days was higher in patients treated with CIC vs placebo Comparator trials CIC 80 qd CIC 320 qd Placebo [12 w] CIC 80 qd CIC 160 qd CIC 320 qd Placebo [12 w] CIC 320 bid CIC 640 bid Placebo [12 w] CIC 320 qd BUD 400 qd [12 w] CIC 160 qd FP 88 bid [12 w] CIC 160 qd A CIC 160 qd P BUD 200 bid [12 w] CIC 320 qd CIC 320 bid BUD 400 bid [8 w] CIC 320 bid FP 330 bid [24 w] CIC 320 qd BUD 320 qd [12 w] CIC 320 qd FP 200 bid [12 w] CIC 80 qd CIC 320 qd BUD 200 bid [12 w] CIC 640 bid PRED 40 mg qd [2 w] 242 n 360 257 250 255 249 47 49 45 399 266 263 139 131 133 319 528 179 180 472 182 195 177 130 60–90 60–85 40–80 NR 80–100 ≥70 NR ≥80 65–95 60–80 73 72 72 NR NR NR 79 77 89 91 93 NR 43.6d 25.8 88 88 Reference Langdon et al. 2005 Pearlman et al. 2005 Bateman et al. 2006b Biberger et al. 2003 Buhl et al. 2004, 2005a,b Niphadkar et al. 2005 Adachi et al. 2006 Bateman et al. 2006c Boulet et al. 2006a Boulet et al. 2006b Hansel et al. 2006 Postma et al. 2006 Similar between groups Similar between groups Similar between groups Similar between groups Approx. 40% for all treatment groups –0.68a (P<0.001) –1.00a (P<0.001) –1.04a (P<0.001) Similar between groups Similar between groups –0.86a (P≤0.001) –1.02a (P≤0.001) –1.04a (P≤0.001) +0.42a 0a 0a +0.5a –0.07a –0.08a +0.32a –1.00a –1.21a NR –0.44c NR 57.5b 53.6b 89b 88b Similar between groups aChange from baseline. bPercentage of days without use. cP=0.029 vs CIC 320qd, P=0.007 vs BUD. dP=0.017. +, increase; –, decrease; bid, twice daily; A, AM; BUD, budesonide; CIC, ciclesonide; FEV1, forced expiratory volume in 1 s; FP, fluticasone propionate; NR, not reported; P, PM; qd, once daily. © 2006 Core Medical Publishing Limited