International guidelines describe asthma control as the main outcome of asthma management. Prevention of symptoms, improved quality of life, and reduction of exacerbations are the main components, consequently decreasing health care costs. However, many of these objectives remain unmet in real life: several surveys show that a large proportion of asthmatic patients are not well controlled despite the efficacy of current available treatment. Several randomized controlled clinical trials indicate that combining inhaled corticosteroids and long-acting β2-agonists, by means of a single inhaler, greatly improves the management of the disease. The results of 9 multicenter phase III clinical studies demonstrate that the fixed combination of fluticasone propionate/formoterol in a single inhaler is effective in terms of lung function and symptom control. These studies highlight the dose flexibility, safety and tolerability of this new inhaled combination. These characteristics meet the recommendations of international guidelines, and the preferences of respiratory physicians who identified these aspects as critical components of a successful asthma therapy. Combination of fluticasone propionate/formoterol in a single inhaler provides potent anti-inflammatory activity of fluticasone propionate and rapid onset of action of the β2-agonist formoterol making this association a viable treatment option both in terms of effectiveness and compliance.
As a result, Trenbolone Acetate now functions as the primary anabolic compound (aka the ‘workhorse’ compound) that will function to provide the muscle growth throughout the cycle. Trenbolone is strictly an advanced level anabolic steroid, unfit for use by beginners of any type. In this cycle, the Acetate variant of Trenbolone is utilized simply due to its seamless compatibility with Testosterone Propionate. This is because the Propionate and Acetate esters as, previously mentioned early on in this section of the profile, both possess almost identical half-lives (3 days for Trenbolone Acetate and days for Testosterone Propionate). This therefore provides an ease of convenience for the user, as well as smoother injection and administration frequencies. The fact that Testosterone is being utilized at a low enough doses to avoid aromatization, combined with the fact that Trenbolone’s inability to convert into Estrogen at any dose should result in the total elimination of any potential water retention, bloating, gynecomastia or any side effects associated with Estrogen . It is important to note that this cycle in particular is strong enough to be utilized as a bulking cycle, lean mass cycle, or cutting cycle – all without the inflated potential for water retention or other Estrogenic side effects .
The precise mechanism through which fluticasone propionate affects rhinitis symptoms is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (., mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (., histamine, eicosanoids, leukotrienes, cytokines) involved in inflammation. In 7 trials in adults, fluticasone propionate nasal spray has decreased nasal mucosal eosinophils in 66% of patients (35% for placebo) and basophils in 39% of patients (28% for placebo). The direct relationship of these findings to long-term symptom relief is not known.