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Budesonide inhalation suspension versus methylprednisolone for treatment of moderate bronchial asthma attacks.

Yanagida N, Tomikawa M, Shukuya A, Iguchi M, Ebisawa M - World Allergy Organ J (2015)

Bottom Line: The cortisol level at discharge was measured.There were no significant differences between the two groups in terms of the severity of attacks and duration of management, or in terms of therapeutic efficacy, duration of wheezing, or period of hospitalization.The frequency of inhalations on days 3 to 6 of hospitalization was lower in the BIS group than in the mPSL group, and the cortisol level at discharge was significantly higher in the BIS group (13.9 ± 6.1 μg/dL) than in the mPSL group (8.0 ± 2.1 μg/dL) (p = 0.008).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.

ABSTRACT

Background: Owing to their side effects, administration of steroids for bronchial asthma attacks should be minimized. We investigated whether budesonide inhalation suspension (BIS) could replace intravenous steroid administration for the treatment of moderate bronchial asthma attacks.

Subjects and methods: The subjects were children aged 5 years and younger hospitalized for moderate bronchial asthma attacks. Patients were randomly assigned to one of two groups: 20 patients received methylprednisolone (mPSL) and 20 were treated with BIS. The mPSL group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and disodium cromoglycate (2 mL) three times a day and systemic administration of mPSL (1 mg/kg) three times a day. The BIS group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and BIS (0.5 mg) three times a day. The frequency of inhalations and steroid administration was adjusted according to the severity of symptoms. The cortisol level at discharge was measured.

Results: There were no significant differences between the two groups in terms of the severity of attacks and duration of management, or in terms of therapeutic efficacy, duration of wheezing, or period of hospitalization. The frequency of inhalations on days 3 to 6 of hospitalization was lower in the BIS group than in the mPSL group, and the cortisol level at discharge was significantly higher in the BIS group (13.9 ± 6.1 μg/dL) than in the mPSL group (8.0 ± 2.1 μg/dL) (p = 0.008).

Conclusion: In patients with recurrent wheezing or bronchial asthma of <5 years, the efficacy of BIS is equivalent or better than mPSL for moderate bronchial asthma attacks, and in contrast to steroid treatment, BIS treatment do not suppress adrenocortical function.

No MeSH data available.


Related in: MedlinePlus

Comparison of the Modified Pulmonary Index Score. The Modified Pulmonary Index Score (MPIS) of the BIS group is shown by the closed line and that of the mPSL group is shown by the open line. No significant difference in the MPIS is seen between the BIS group and the mPSL group. Abbreviations: mPSL, methylprednisolone; BIS, budesonide inhalation suspension; MPIS, Modified Pulmonary Index Score.
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Fig1: Comparison of the Modified Pulmonary Index Score. The Modified Pulmonary Index Score (MPIS) of the BIS group is shown by the closed line and that of the mPSL group is shown by the open line. No significant difference in the MPIS is seen between the BIS group and the mPSL group. Abbreviations: mPSL, methylprednisolone; BIS, budesonide inhalation suspension; MPIS, Modified Pulmonary Index Score.

Mentions: The number of inhalations with procaterol during hospitalization was 10.5 ± 3.5 times in the BIS group, which was lower by approximately two-thirds than the value in the mPSL group (16.6 ± 5.4), and this difference was significant (p < 0.001). Cortisol levels at discharge were measured in 15 patients in the mPSL group and 18 patients in the BIS group. Cortisol levels could not be measured in five patients in the mPSL group and in two patients in the BIS group who were discharged on a weekend or national holiday. ECP levels at discharge could be measured only in seven patients in the mPSL group and 13 patients in the BIS group because of problems with sample processing. There was no significant difference in ECP levels at discharge (33.7 ± 25.8 μg/L in the mPSL group and 30.7 ± 31.1 μg/L in the BIS group). The respiratory status was evaluated using the MPIS (Figure 1), and no significant difference was observed between the groups at any time point.Figure 1


Budesonide inhalation suspension versus methylprednisolone for treatment of moderate bronchial asthma attacks.

Yanagida N, Tomikawa M, Shukuya A, Iguchi M, Ebisawa M - World Allergy Organ J (2015)

Comparison of the Modified Pulmonary Index Score. The Modified Pulmonary Index Score (MPIS) of the BIS group is shown by the closed line and that of the mPSL group is shown by the open line. No significant difference in the MPIS is seen between the BIS group and the mPSL group. Abbreviations: mPSL, methylprednisolone; BIS, budesonide inhalation suspension; MPIS, Modified Pulmonary Index Score.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4419502&req=5

Fig1: Comparison of the Modified Pulmonary Index Score. The Modified Pulmonary Index Score (MPIS) of the BIS group is shown by the closed line and that of the mPSL group is shown by the open line. No significant difference in the MPIS is seen between the BIS group and the mPSL group. Abbreviations: mPSL, methylprednisolone; BIS, budesonide inhalation suspension; MPIS, Modified Pulmonary Index Score.
Mentions: The number of inhalations with procaterol during hospitalization was 10.5 ± 3.5 times in the BIS group, which was lower by approximately two-thirds than the value in the mPSL group (16.6 ± 5.4), and this difference was significant (p < 0.001). Cortisol levels at discharge were measured in 15 patients in the mPSL group and 18 patients in the BIS group. Cortisol levels could not be measured in five patients in the mPSL group and in two patients in the BIS group who were discharged on a weekend or national holiday. ECP levels at discharge could be measured only in seven patients in the mPSL group and 13 patients in the BIS group because of problems with sample processing. There was no significant difference in ECP levels at discharge (33.7 ± 25.8 μg/L in the mPSL group and 30.7 ± 31.1 μg/L in the BIS group). The respiratory status was evaluated using the MPIS (Figure 1), and no significant difference was observed between the groups at any time point.Figure 1

Bottom Line: The cortisol level at discharge was measured.There were no significant differences between the two groups in terms of the severity of attacks and duration of management, or in terms of therapeutic efficacy, duration of wheezing, or period of hospitalization.The frequency of inhalations on days 3 to 6 of hospitalization was lower in the BIS group than in the mPSL group, and the cortisol level at discharge was significantly higher in the BIS group (13.9 ± 6.1 μg/dL) than in the mPSL group (8.0 ± 2.1 μg/dL) (p = 0.008).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.

ABSTRACT

Background: Owing to their side effects, administration of steroids for bronchial asthma attacks should be minimized. We investigated whether budesonide inhalation suspension (BIS) could replace intravenous steroid administration for the treatment of moderate bronchial asthma attacks.

Subjects and methods: The subjects were children aged 5 years and younger hospitalized for moderate bronchial asthma attacks. Patients were randomly assigned to one of two groups: 20 patients received methylprednisolone (mPSL) and 20 were treated with BIS. The mPSL group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and disodium cromoglycate (2 mL) three times a day and systemic administration of mPSL (1 mg/kg) three times a day. The BIS group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and BIS (0.5 mg) three times a day. The frequency of inhalations and steroid administration was adjusted according to the severity of symptoms. The cortisol level at discharge was measured.

Results: There were no significant differences between the two groups in terms of the severity of attacks and duration of management, or in terms of therapeutic efficacy, duration of wheezing, or period of hospitalization. The frequency of inhalations on days 3 to 6 of hospitalization was lower in the BIS group than in the mPSL group, and the cortisol level at discharge was significantly higher in the BIS group (13.9 ± 6.1 μg/dL) than in the mPSL group (8.0 ± 2.1 μg/dL) (p = 0.008).

Conclusion: In patients with recurrent wheezing or bronchial asthma of <5 years, the efficacy of BIS is equivalent or better than mPSL for moderate bronchial asthma attacks, and in contrast to steroid treatment, BIS treatment do not suppress adrenocortical function.

No MeSH data available.


Related in: MedlinePlus