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Inhaled Budesonide (inhaled + budesonide)

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Medical Sciences	100%

Selected Abstracts

Effectiveness of early budesonide intervention in Caucasian versus Asian patients with asthma: 3-year results of the START study

RESPIROLOGY, Issue 6 2006
Wan C. TAN
Objective and background: Few studies have assessed the effectiveness of inhaled corticosteroid therapy exclusively in Asian patients with asthma. The present analysis compared the efficacy of early intervention with inhaled budesonide in Caucasian and Asian patients over the first 3 years of the inhaled Steroid Treatment As Regular Therapy in early asthma study. Methods: Patients aged 5,66 years with mild persistent asthma of ,2 years' duration were randomized to 3 years of double-blind treatment with once-daily budesonide 200 µg (for patients aged <11 years) or 400 µg administered via Turbuhaler or placebo, plus usual asthma therapy. Results: Budesonide significantly improved asthma outcomes in both Caucasian (n = 4661) and Asian (n = 1995) patients compared with reference therapy (placebo plus usual asthma therapy). Budesonide reduced the risk of a first severe asthma-related event by 42% and 49% in Caucasian and Asian patients, respectively, over the 3-year treatment period (P < 0.001 for both). Moreover, budesonide significantly increased symptom-free days, decreased nights with sleeping problems, improved pre- and postbronchodilator FEV1 and reduced the need for additional asthma medications of particular drug classes compared with reference therapy. Except for differences in the patterns of use of additional asthma medications, outcomes with budesonide and overall adverse events were similar in the Caucasian and Asian patient populations. Conclusion: Inhaled budesonide administered once daily in Asian patients with recent-onset, mild persistent asthma significantly improved asthma control and pulmonary function compared with reference therapy. Moreover, this effectiveness paralleled that observed in Caucasian patients. [source]

Budesonide delivered by dosimetric jet nebulization to preterm very low birthweight infants at high risk for development of chronic lung disease

ACTA PAEDIATRICA, Issue 12 2000
B Jónsson
We investigated the effect of an aerosolized corticosteroid (budesonide) on the oxygen requirement of infants at high risk for developing chronic lung disease (CLD) in a randomized, double-blind study. The study objective was to attain a 30% decrease in FiO2 levels in the budesonide treatment group after 14 d of therapy. Thirty very low birthweight (VLBW) infants (median (range)) gestational age 26 wk (23,29) and birthweight 805 g (525,1227) were randomized. Inclusion criteria were mechanical ventilation on day 6 of life, or if extubated on nasal continuous positive airway pressure with FiO2± 0.3. The budesonide (PulmicortÔ dose was 500 ,g bid, or placebo. The aerosol was delivered with a dosimetric jet nebulizer, with variable inspiratory time and breath sensitivity. Inhalations were started on day 7 of life. Twenty-seven patients completed the study. A significant lowering of the FiO2 levels at 21 d of life was not detected. Infants who received budesonide were more often extubated during the study period (7/8 vs 2/9) and had a greater relative change from baseline in their oxygenation index (budesonide decreased 26% vs placebo increased 60%). Subsequent use of intravenous dexamethasone or inhaled budesonide in the treatment group was significantly less. All patients required O2 supplementation on day 28 of life. At 36 wk postconceptual age, 61% of infants in the budesonide group needed supplemental O2 as opposed to 79% in the placebo group. No side effects on growth or adrenal function were observed Conclusion: We conclude that inhaled budesonide aerosol via dosimetric jet nebulizer started on day 7 of life for infants at high risk for developing CLD decreases the need for mechanical ventilation similar to intravenous dexamethasone, but without significant side effects. [source]

A Randomized Controlled Trial of Mist in the Acute Treatment of Moderate Croup

ACADEMIC EMERGENCY MEDICINE, Issue 9 2002
Gina M. Neto MD
Abstract Objective: To determine whether the use of mist improves clinical symptoms in children presenting to the emergency department (ED) with moderate croup. Methods: Children 3 months to 6 years of age were eligible for the study if they presented to the ED with moderate croup. Moderate croup was defined as a croup score of 2-7. The patients were randomly assigned to receive either mist (humidified oxygen) via mist stick or no mist. The patients had croup scores measured at baseline and every 30 minutes for up to two hours. At these intervals the following parameters were also measured: heart rate, respiratory rate, oxygen saturation, and patient comfort score. The patients were treated until the croup score was less than 2 or until two hours had elapsed. All patients initially received a dose of oral dexamethasone (0.6 mg/kg). Other treatments, such as racemic epinephrine or inhaled budesonide, were given at the discretion of the treating physician. The research assistants were unaware of the assigned treatments. Results: There were 71 patients enrolled in the study; 35 received mist and 36 received no mist. The two treatment groups had similar characteristics at baseline. The median baseline croup score was 4 in both groups. The outcomes were measured as the change from baseline at 30, 60, 90, and 120 minutes. The change in the croup score from baseline in the mist group was not statistically different from the croup score change in the group that did not receive mist (p = 0.39). There was also no significant difference in improvement of oxygen saturation, heart rate, or respiratory rate at any of the assessment times. There was no adverse effect from the mist therapy. Conclusions: Mist therapy is not effective in improving clinical symptoms in children presenting to the ED with moderate croup. [source]

Corticosteroid use and risk of hip fracture: a population-based case,control study in Denmark

JOURNAL OF INTERNAL MEDICINE, Issue 5 2003
P. Vestergaard
Abstract. Vestergaard P, Olsen ML, Paaske Johnsen S, Rejnmark L, Toft Sørensen H, Mosekilde L (Aarhus University Hospital, Denmark; and Aarhus and Aalborg University Hospitals; Aarhus, Denmark). Corticosteroid use and risk of hip fracture: a population-based case,control study in Denmark. J Intern Med 2003; 254: 486,493. Background. Corticosteroids (CS) are used in a wide range of conditions but have several possible adverse effects including an increased risk of osteoporotic fractures. Objective. To examine the association between cumulative CS dose and risk of hip fracture. Design. Population-based case,control design. Subjects and methods. A total of 6660 subjects with hip fracture and 33 272 age-matched population controls were identified using the County Hospital Discharge Registry in North Jutland County, Denmark and the Danish Central Personal Registry, respectively. Data on redeemed prescriptions for CS within the last 5 years before the index date were retrieved from a population-based prescription database, and recalculated to prednisolone equivalents. Cases and controls were categorized according to cumulative CS dose: (i) no use; (ii) <130 mg (e.g. equivalent to 30 mg of prednisolone for 4 days given for an acute exacerbation of asthma); (iii) 130,499 mg (e.g. equivalent to a short course of prednisolone of 450 mg for acute asthma); (iv) 500,1499 mg (e.g. equivalent to 7.5 mg prednisolone daily for 6 months or 800 ,g day,1 of inhaled budesonide for 1 year); and (v) ,1500 mg (e.g. equivalent to >4.1 mg day,1 for 1 year, a long-term high dose). Data were analysed using conditional logistic regression adjusted for potential confounders including gender, redeemed prescriptions for hormone replacement therapy, antiosteoporotic, anxiolytic, antipsychotic and antidepressant drugs. Results. Compared with never users, an increased risk of hip fracture was found for CS users, with increasing cumulative doses of any type of CS use during the preceding 5 years [adjusted odds ratio (OR) = 0.96, 95% confidence interval (CI) = 0.89,1.04] for <130 mg prednisolone; OR = 1.17 (CI = 1.01,1.35) for 130,499 mg; OR = 1.36 (CI = 1.19,1.56) for 500,1499 mg; and OR = 1.65 (CI = 1.43,1.92) for ,1500 mg. An increased risk was also found when the study population was stratified according to gender, age and type of CS (systemic or topical). Conclusions. Even a limited daily dose of CS (more than an average dose of approximately 71 ,g prednisolone per day) was associated with an increased risk of hip fracture. [source]

Inhaled corticosteroids during and after respiratory syncytial virus-bronchiolitis may decrease subsequent asthma

PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 3 2000
Merja Kajosaari
Respiratory syncytial virus (RSV) bronchiolitis in infancy can lead to bronchial hyper-reactivity or recurrent obstructive bronchitis. The aim of the present study was to determine whether the type of treatment has an influence on respiratory status after RSV bronchiolitis. The study involved 117 infants (mean age 2.6 months), who needed hospital treatment because of RSV bronchiolitis. The patients were divided randomly into three groups. All received the same symptomatic treatment. Group I children received symptomatic treatment only, group II children were treated for 7 days with inhaled budesonide, 500 µg three times per day, administered via a nebulizer. Group III children received nebulized budesonide, 500 µg twice per day for two months. Follow-up consisted of out-patient check-ups 2 and 6 months after the infection, and telephone contact two years after the infection. Statistically significant differences were seen between the groups. In group I 37% of the children had asthma, in group II 18%, and in group III 12%. According to the present study it seems that inhaled corticosteroid treatment during and after the acute phase of infant RSV bronchiolitis may have a beneficial effect on subsequent bronchial wheezing tendency. [source]

Effectiveness of early budesonide intervention in Caucasian versus Asian patients with asthma: 3-year results of the START study

Inhaled corticosteroid for persistent cough following upper respiratory tract infection

RESPIROLOGY, Issue 4 2005
Prapaporn PORNSURIYASAK
Objective: The aim of this study was to determine the clinical effect of inhaled corticosteroid treatment for persistent cough, post upper respiratory tract infection (URTI) in previously healthy individuals, and on bronchial hyperresponsiveness (BHR). Methodology: This was a prospective, randomized, double-blinded, placebo-controlled study conducted at a university hospital. A total of 30 non-asthmatic, non-smoking patients who were >15 years old and who had persistent post-URTI cough for >3 weeks were assessed by a physical examination, CXR and spirometry, and were allocated to receive inhaled budesonide (400 µg/puff, twice daily) or placebo for 4 weeks. If a patient suffered from sinusitis, it was a requirement that it had been well treated. A symptom score (frequency of cough, frequency of coughing bouts, symptoms associated with cough, night-time cough, frequency of taking medications to relieve cough, and number of medications) was recorded at entry, and after 2 and 4 weeks of treatment. A methacholine challenge test was performed at entry and after 4 weeks of treatment. Results: The mean symptom scores for the treatment group (9.4) and the placebo group (9.8) at baseline were not significantly different (P = 0.79), and no differences were found between the groups after week 2 and week 4 of treatment (3.93 and 4.27 vs 2.26 and 2.66, P = 0.29). The mean change in symptom scores from baseline to week 2 and to week 4 of treatment were also not different between groups (5.93 and 5.6 vs 7.00 and 7.58, P = 0.23). No difference between groups was found in the mean changes in FEV1, FVC, and FEF25,75% after 4 weeks of treatment. A positive bronchial provocation test occurred in three patients (10%) but these were borderline. Conclusion: Inhaled corticosteroid is ineffective in treating persistent post-URTI cough in previously healthy individuals. [source]