Usefulness of suplatast tosilate in patients with mild bronchial asthma - Comparison with beclomethasone dipropionate

Background: Suplatast tosilate is a type 2 (Th2) cytokine inhibitor that blocks the production of IgE antibodies and the invasion of tissues by eosinophils during an allergic reaction. Suplatast tosilate ameliorates asthma symptoms and airway hypersensitivity by inhibiting production of the Th2 cytokines interleukin (IL)-4 and IL-5. Methods: In the present study, a comparative examination of the therapeutic effects of suplatast tosilate was carried out in patients with mild intermittent and mild persistent asthma by randomly allocating 35 adult patients to a suplatast tosilate group (n = 18; 100 mg suplatast tosilate three times daily) and a beclomethasone dipropionate (BDP) group (n = 17; 200 μg BDP twice daily) for 6 weeks of treatment. Results: The suplatast tosilate group required more time than the BDP group to show improvement in peak expiratory flow, but at week 6 the change from baseline was nearly the same in both groups. A significant improvement was observed for both groups in the peripheral blood eosinophil ratio, serum eosinophil cationic protein (ECP) levels, induced sputum ECP levels, forced expiratory volume in 1 second, and airway hypersensitivity, but induced sputum ECP level was lower in the BDP group than in the suplatast tosilate group. Total IgE levels decreased in the suplatast tosilate group only. Conclusions: We conclude that suplatast tosilate may be useful in long-term management of mild bronchial asthma.