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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 plasma cortisol levels. The plasma cortisol level at discharge is significantly higher in the BIS group than in the mPSL group. Abbreviations: mPSL, methylprednisolone; BIS, budesonide inhalation suspension.
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Fig3: Comparison of plasma cortisol levels. The plasma cortisol level at discharge is significantly higher in the BIS group than in the mPSL group. Abbreviations: mPSL, methylprednisolone; BIS, budesonide inhalation suspension.

Mentions: Figure 3 shows a comparison of cortisol levels before and after hospitalization. Cortisol levels at discharge decreased significantly compared with preadmission levels in both the mPSL and BIS groups. There was no significant difference between the two groups in terms of cortisol levels on admission, but at discharge, the levels were significantly higher in the BIS group (13.9 ± 6.8 μg/dL) than in the mPSL group (8.0 ± 7.1 μg/dL; p = 0.008).Figure 3


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 plasma cortisol levels. The plasma cortisol level at discharge is significantly higher in the BIS group than in the mPSL group. Abbreviations: mPSL, methylprednisolone; BIS, budesonide inhalation suspension.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Comparison of plasma cortisol levels. The plasma cortisol level at discharge is significantly higher in the BIS group than in the mPSL group. Abbreviations: mPSL, methylprednisolone; BIS, budesonide inhalation suspension.
Mentions: Figure 3 shows a comparison of cortisol levels before and after hospitalization. Cortisol levels at discharge decreased significantly compared with preadmission levels in both the mPSL and BIS groups. There was no significant difference between the two groups in terms of cortisol levels on admission, but at discharge, the levels were significantly higher in the BIS group (13.9 ± 6.8 μg/dL) than in the mPSL group (8.0 ± 7.1 μg/dL; p = 0.008).Figure 3

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