The effect of inhaled budesonide on symptoms, lung function, and cold air and methacholine responsiveness in 2-to 5-year-old asthmatic children

被引:117
作者
Nielsen, KG [1 ]
Bisgaard, H [1 ]
机构
[1] Univ Copenhagen Hosp, Rigshosp, Dept Pediat, DK-2100 Copenhagen, Denmark
关键词
D O I
10.1164/ajrccm.162.4.2002019
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
We hypothesized that measurement of lung function (LF) and bronchial hyperresponsiveness (BHR) could serve as supplemental tools in evaluating the efficacy of treatment with inhaled corticosteroids in asthmatic children aged 2 to 5 yr. We studied 38 children (mean age: 53 mo; range: 35 to 71 mo) with moderately severe asthma in a single-center, randomized, double-blind, parallel-group, placebo-controlled study involving 8 wk of treatment. Budesonide (BUD) 400 mu g twice daily was administered via a pressurized metered-dose inhaler and metal spacer device. Symptom scores (SSc) and use of short-acting beta(2)-agonist were monitored with diary cards. LF in awake children was measured as the specific airway resistance (sRaw), using whole-body plethysmography; as resistance by the interrupter technique (Rint); and as resistance and reactance at 5 Hz (Rrs5, Xrs5) by the impulse oscillation technique. Cold air challenge (CACh) and methacholine challenge (MCh) were used to assess BHR. Children in the BUD group experienced significantly fewer night- and daytime symptoms (p < 0.05) and more symptom-free days (p < 0.05), but not nights (p = 0.07), than children in the placebo group. Daytime (p < 0.05) but not nighttime (p = 0.09) use of rescue medication and asthma exacerbation rates (3.7 versus 9.3 exacerbations/yr) (p = 0.006) were both in favor of BUD. LF measured with the Rint technique, Rrs5, and Xrs5 were significantly improved by BUD. BHR as measured by CACh improved significantly with BUD, whereas no improvement was found on MCh. In conclusion, inhaled BUD at a total dose of 800 mu g daily significantly Improved SSc, asthma exacerbation rates, lung function, and BHR as assessed by CACh in asthmatic children aged 2 to 5 yr.
引用
收藏
页码:1500 / 1506
页数:7
相关论文
共 35 条
[1]   A multiple-dosing, placebo-controlled study of budesonide inhalation suspension given once or twice daily for treatment of persistent asthma in young children and infants [J].
Baker, JW ;
Mellon, M ;
Wald, J ;
Welch, M ;
Cruz-Rivera, M ;
Walton-Bowen, K .
PEDIATRICS, 1999, 103 (02) :414-421
[2]   INHALED BUDESONIDE FOR TREATMENT OF RECURRENT WHEEZING IN EARLY-CHILDHOOD [J].
BISGAARD, H ;
MUNCK, SL ;
NIELSEN, JP ;
PETERSEN, W ;
OHLSSON, SV .
LANCET, 1990, 336 (8716) :649-651
[3]   The effect of inhaled fluticasone propionate in the treatment of young asthmatic children - A dose comparison study [J].
Bisgaard, H ;
Gillies, J ;
Groenewald, M ;
Maden, C .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1999, 160 (01) :126-131
[4]   Bronchoprotection with a leukotriene receptor antagonist in asthmatic preschool children [J].
Bisgaard, H ;
Nielsen, KG .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2000, 162 (01) :187-190
[5]   Lung function measurement in awake young children [J].
Bisgaard, H ;
Klug, B .
EUROPEAN RESPIRATORY JOURNAL, 1995, 8 (12) :2067-2075
[6]  
Claussen M, 1993, Pneumologie, V47, P209
[7]   USE OF BUDESONIDE IN SEVERE ASTHMATICS AGED 1-3 YEARS [J].
CONNETT, GJ ;
WARDE, C ;
WOOLER, E ;
LENNEY, W .
ARCHIVES OF DISEASE IN CHILDHOOD, 1993, 69 (03) :351-355
[8]  
DEAL EC, 1980, AM REV RESPIR DIS, V121, P621
[9]   COMPARISON OF AIRWAY REACTIVITY INDUCED BY COLD-AIR AND METHACHOLINE CHALLENGES IN ASTHMATIC-CHILDREN [J].
DEBENEDICTIS, FM ;
CANNY, GJ ;
MACLUSKY, IB ;
LEVISON, H .
PEDIATRIC PULMONOLOGY, 1995, 19 (06) :326-329
[10]   Efficacy of nebulized budesonide in treatment of severe infantile asthma: A double-blind study [J].
deBlic, J ;
Delacourt, C ;
LeBourgeois, M ;
Mahut, B ;
Ostinelli, J ;
Caswell, C ;
Scheinmann, P .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1996, 98 (01) :14-20