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Low-dose inhaled budesonide once or twice daily for 27 months in children with mild asthma

G Jónasson1, K H Carlsen, C Jonasson

  • 1Paediatric Section for Allergy and Pulmonology, Ullevål Hospital, Oslo, Norway.

Allergy
|August 24, 2000
PubMed

Insights

Low-dose inhaled budesonide (BUD) is safe and effective for children with mild asthma, significantly reducing exercise-induced symptoms and improving lung function over 27 months.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Pharmacology

Background:

  • Mild asthma in children requires effective long-term management strategies.
  • Inhaled corticosteroids are a cornerstone of asthma therapy, but long-term effects need evaluation.
  • Previous short-term studies suggested efficacy of low-dose inhaled budesonide (BUD).

Purpose of the Study:

  • To evaluate the long-term clinical efficacy and safety of low-dose inhaled budesonide (BUD) in children with mild asthma.
  • To compare once-daily versus twice-daily administration of BUD.
  • To assess the dose-response relationship of inhaled BUD.

Main Methods:

  • Extended follow-up (24 months) of a 12-week trial involving 122 children with mild asthma.
  • Double-blind, randomized, parallel-group study comparing inhaled BUD (100 or 200 microg once daily, 100 microg twice daily) or placebo for 27 months.
  • Regular exercise and methacholine challenges performed to assess bronchial hyperreactivity and lung function (FEV1, FEF25%, FEV50%).

Main Results:

  • A significant dose-response effect favoring BUD 200 microg daily was observed for lung function parameters (FEV1, FEF25%, FEV50%) and reduced fall in FEV1 after exercise.
  • Bronchial hyperreactivity to methacholine significantly decreased with BUD 200 microg daily compared to placebo.
  • Growth rate was not significantly affected, with a minor exception in children aged 7-11 years at baseline after 12 months.

Conclusions:

  • Low-dose inhaled budesonide (100 or 200 microg daily) is safe and effective for long-term management of mild asthma in children.
  • Treatment protects against exercise-induced asthma and helps maintain near-normal lung function.
  • The 200 microg daily dose demonstrated a superior dose-response effect compared to the 100 microg daily dose.

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