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

World Allergy Organization Journal

Motohiro Ebisawa¹  Masamichi Iguchi²  Akinori Shukuya²  Morimitsu Tomikawa²  Noriyuki Yanagida² 

[1] Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan;Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan

关键词: Procaterol;    Cortisol;    Inhalation;    Budesonide;    Methylprednisolone;    Asthma;   

Others  :  1180918
DOI  :  10.1186/s40413-015-0065-0

 received in 2015-01-22, accepted in 2015-03-18,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Yanagida et al.; licensee BioMed Central.

【 图 表 】

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