Inhaled mometasone furoate for the management of refractory oral corticosteroid-dependent asthma: a case report

We report a case study of a 55-year-old white male with severe persistent refractory corticosteroid-dependent asthma receiving inhaled combination therapy with fluticasone propionate 500 μg and salmeterol 50 μg twice-daily in addition to 6-week cycles of oral corticosteroid treatment for the previous 7 months. The patient was switched to high-dose mometasone furoate delivered via a dry powder inhaler (660 μg twice-daily) for 6 weeks. Considerable improvement from baseline in peak expiratory flow, use of rescue medication, and asthma symptoms of coughing and wheezing was observed. The patient discontinued the oral corticosteroid after 1 week of high-dose mometasone furoate treatment. Plasma cortisol value at 8 a.m. was 8.4 μg/dL (normal range, 4.3-22.6 μg/dL) at week 6.