ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Beclomethasone inhalers safe to use with PIs
Protease inhibitors are known to increase plasma concentrations of inhaled fluticasone, resulting in secondary adrenal insufficiency. Two papers 810 and 811 reported on the safety of the inhaled steroid, beclomethasone dipropionate (BDP) with ritonavir (RTV) or darunavir/ritonavir (DRV/r).
Paper 810 was an open-label, prospective, randomized study to determine whether inhaled BDP when combined with ritonavir (RTV) or darunavir/ritonavir (DRV/r) significantly influences adrenal function in HIV– healthy volunteers. Combined use of BDP and RTV or DRV/r for 28 days did not cause significant adrenal suppression in healthy volunteers.
Paper 811 from the same study found that DRV/r does not significantly increase the AUC of 17-BMP, while RTV alone produces a statistically significant (p .05)—but clinically inconsequential—2-fold increase in 17-BMP exposure.
In summary patients receiving PIs and requiring an inhaled corticosteroid inhaled BDP is preferable to fluticasone.