Inhaled beclomethasone dipropionate in allergic bronchopulmonary aspergillosis. Report to the Research Committee of the British Thoracic Association.

A double-blind multi-centre study was carried out to assess the effects of beclomethasone dipropionate aerosol on the control of symptoms of asthma and on fungal colonization of the bronchi, in patients with allergic bronchopulmonary aspergillosis who had not been treated with an inhaled corticosteroid preparation for at least six months. Each of the 32 patients who completed the trial was treated with beclomethasone (100 microgram four times daily) or placebo aerosol for consecutive periods of six months without alteration of the pre-study maintenance therapy. Treatment of exacerbations of asthma and of pulmonary eosinophilia was left to the discretion of the participating physicians. The only statistically significant finding was an association between serum Aspergillus antibody levels and episodes of pulmonary eosinophilia diagnosed by radiography. During treatment with beclomethasone improvement occurred in ventilatory function and control of asthma, but Aspergillus fumigatus was detected in the sputum more frequently than during the placebo period. None of these trends attained statistical significance. Episodes of pulmonary eosinophilia were not reduced by beclomethasone and usually occurred without clinical deterioration of asthma.