Inhaled budesonide for adults with mild-to-moderate asthma

a randomized placebo-controlled, double-blind clinical trial

Authors

  • Ana Luisa Godoy Fernandes Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica
  • Sonia Maria Faresin Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica
  • Maria Marta Amorim Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica
  • Carlos Cézar Fritscher Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica
  • Carlos Alberto de Castro Pereira Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica
  • José Roberto Jardim Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica

Keywords:

Asthma, Inhaled corticosteroid, Budesonide

Abstract

CONTEXT: Budesonide is an inhaled corticosteroid with high topical potency and low systemic activity recommended in he treatment of chronic asthma. OBJECTIVE: This study was conducted to determine the efficacy and safety of inhaled budesonide via a breath-activated, multi-dose, dry-powder inhaler. TYPE OF STUDY: Multicenter randomized parallel-group, placebo-controlled, double-blind, clinical trial. SETTING: Multicenter study in the university units. PARTICIPANTS: Adult patients with mild-to-moderate asthma that was not controlled using bronchodilator therapy alone. PROCEDURES: Comparison of budesonide 400 µg administered twice daily via a breath-activated, multi-dose, dry-powder inhaler with placebo, in 43 adult patients (aged 15 to 78 years) with mild-to-moderateasthma(FEV171%ofpredicted normal) that was not controlled using bronchodilator therapy alone. MAIN MEASUREMENTS: Efficacy was assessed by pulmonaryfunction tests and asthma symptom control (as perceived by the patients) and the use of rescue medication. RESULTS: Budesonide 400 µg (bid) was significantly more effective than placebo in improving morningpeakexpiratoryflow(meandifference: 67.9 l/min; P < 0.005) and FEV1 (mean difference: 0.60 l; P < 0.005) over the 8-week treatment period. Onset of action, assessed by morning peak expiratory flow, occurred within the first two week sof treatment. CONCLUSIONS: Budesonide via a breath-activated, multi-dose,dry-powder in haler results in a rapid on set of asthma control, which is main tained over time and is well tolerated in adults with mild-to- moderate asthma.

Downloads

Download data is not yet available.

Author Biographies

Ana Luisa Godoy Fernandes, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica

MD, PhD. Associate Professor of Respirology Division, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.

Sonia Maria Faresin, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica

MD, PhD. Orienting Professor of Respirology Division, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.

Maria Marta Amorim, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica

MSc. Biomedical, Respirology Division, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.

Carlos Cézar Fritscher, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica

MD. Chairman of Respirology, Professor of Pneumology, Pontifícia Universidade Católica, Rio Grande do Sul, Brazil.

Carlos Alberto de Castro Pereira, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica

MD, PhD. Hospital do Servidor Público Estadual; Orienting Professor of Pneumology, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.

José Roberto Jardim, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital do Servidor Público Estadual; Pontifícia Universidade Católica

MD, PhD. Associate Professor of Respirology Division, Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.

References

Cochrane GM, Jackson WF, Rees PJ. Epidemiology of asthma. In: Asthma current perspectives, London: Mosby-Wolfe; 1996:5-12.

Peat JK, Van Den Berg RH, Green WF, et al. Changing prevalence of asthma in Australian children. Br Med J 1994;308:1591-6.

Fritscher CC, Severo RD, Fagundes SC. Modifications in the prevalence of asthma in schools in Porto Alegre. J Pneumol 1994;20:6-10.

Barnes NC, Hallet C, Harris AJ. Clinical experience with fluticasone propionate in asthma: meta-analysis of efficacy and systemic activity compared with budesonide and beclomethasone dipropionate at half microgram doses or less. Respir Med 1998;92:95-104

Barnes NC, Thwaites RM, Price MJ. The cost-effectiveness of inhaled fluticasone propionate and budesonide in the treatment of asthma in adults and children. Respir Med Jun 1999;93:402-7

Konig P. Inhaled corticosteroids: their present and role in the management of asthma. J Allergy Clin lmmunol 1988;82:297-306.

Benson HA, Prankerd RJ. Optimization of drug delivery: pulmonary drug delivery. Aust J Hosp Pharm 1998;28:18-23.

National Heart, Lung and Blood Institute (NHLBI); National Institutes of Health. Executive summary: Guidelines for the diagnosis and management of asthma (Publication no. 91, 3042A). Bethesda: NHLBI; 1991:1-3.

Sociedade Brasileira de Alergia e Imunopatologia; Sociedade Brasileira de Pediatria; Sociedade Brasileira de Pneumologia e Fisiologia. I Consenso Brasileiro no Manejo da Asma. Fortaleza: 1994.

National Heart, Lung and Blood Institute (NHLBI); National Institutes of Health. Global initiative for asthma: global strategy for asthma management and prevention. NHLBI/WHO (Workshop Report Publication no. 95, 3659). Bethesda: NHLBI; 1995.

Sociedade Brasileira de Alergia e Imunopatologia; Sociedade Brasileira de Pediatria; Sociedade Brasileira de Pneumologia e Fisiologia. II Consenso Brasileiro no Manejo da Asma, 1998. J Pneumologia 1998;24:171-276.

Hatoum HT, Shumock GT, Kendziersk DL. Meta-analysis of controlled trials of drug therapy in mild chronic asthma: the role of inhaled corticosteroids. Ann Pharmacother 1994;28:1285-9.

Consenso Brasileiro de Espirometria. J Pneumologia 1996;22(3):103-57.

Sourk RL, Nugent KM. Bronchodilator testing: confidence intervals derived from placebo inhalations. Am Rev Respir Dis 1983;128:153-7.

Woolcock S, Lundback B, Ringdal N, et al. Comparison of addition of salmeterol to inhaled steroids with doubling of the dose of inhaled steroids. Am J Respir Crit Care Med 1996;153:1481-8.

Pauwels RA, Löfdahl CG, Postma DS, et al. Effect of inhaled formoterol and budesonide on exacerbations of asthma: Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. N Engl J Med 1997;337:1405-11.

Busse W, Maisiak R, Young Jr R. Treatment regimen and side effects of treatment measures. Am J Respir Crit Care Med 1994;149:S44-S50.

Kemp J, Wanderer AA, Ramsdell J, et al. Rapid onset of control with budesonide Turbohaler in patients with mild-to-moderate asthma. Ann Allergy Asthma Immunol 1999;82:463-71

Busse W, Chervinsky P, Condemi J, Lumry WR, Petty TL, Rennard S, Townley RG. Budesonide delivered by Turbohaler is effective in a dose-dependent fashion when used in the treatment of adult patients with chronic asthma. J. Allergy Clin Immunol 1998;101(3):457-63

Enright PL, Lebowitz MD, Cockroft DW. Physiologic measures: pulmonary function tests, asthma outcome. Am J Respir Crit Care Med 1994;149:S9-S18.

Tattersfield AE, Postma DS, Barnes PJ, et al. Exacerbations of asthma: a descriptive study of 425 severe exacerbations. The FACET International Study Group. Am J Respir Crit Care Med 1999;160:594-9.

Downloads

Published

2001-09-09

How to Cite

1.
Fernandes ALG, Faresin SM, Amorim MM, Fritscher CC, Pereira CA de C, Jardim JR. Inhaled budesonide for adults with mild-to-moderate asthma: a randomized placebo-controlled, double-blind clinical trial. Sao Paulo Med J [Internet]. 2001 Sep. 9 [cited 2025 Mar. 15];119(5):169-74. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2780

Issue

Section

Original Article