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Effect of inhaled budesonide therapy on lung function in schoolchildren born preterm
A S Pelkonen1, A L Hakulinen, M Hallman
1Department of Allergic Diseases, Helsinki University Central Hospital, Finland.
Insights
Inhaled budesonide did not significantly improve lung function in preterm schoolchildren. However, this treatment may reduce bronchial lability, indicating a potential benefit for airway hyperresponsiveness.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Research
Background:
- Preterm birth is associated with increased risk of respiratory issues, including bronchial obstruction and hyperresponsiveness.
- Inhaled glucocorticoids (GCs) are commonly used to manage airway inflammation, but their efficacy in preterm-born children with bronchial obstruction requires further investigation.
Purpose of the Study:
- To evaluate the effect of inhaled budesonide on bronchial obstruction and bronchial lability in schoolchildren born preterm.
- To assess changes in spirometric values and diurnal peak expiratory flow (PEF) variation during budesonide treatment.
Main Methods:
- An open, longitudinal study involving 18 preterm-born schoolchildren (median gestational age 28 weeks) with bronchial obstruction or hyperresponsiveness.
- Treatment with inhaled budesonide (0.8 mg/day for 1 month, then 0.4 mg/day for 3 months).
- Assessment of daily symptom scores, clinic spirometry, and home-based PEF monitoring using a data storage spirometer.
Main Results:
- No significant changes were observed in clinic spirometric values, including forced expiratory volume in 1 second (FEV1), which remained at a median of 74% of predicted.
- A significant decrease was noted in the median number of days with > or = 20% diurnal variation in PEF values at home during budesonide treatment.
- Daily symptom scores were recorded but not explicitly detailed in the abstract's main findings.
Conclusions:
- Four months of inhaled budesonide treatment did not significantly alter basic lung function parameters in preterm-born schoolchildren.
- Inhaled budesonide may have a beneficial effect in reducing bronchial lability, suggesting potential for managing airway hyperresponsiveness in this population.
- Further research is warranted to confirm these findings and explore long-term outcomes.
Abstract:
We investigated the effect of inhaled glucocorticoid (GC) on bronchial obstruction and on bronchial lability in schoolchildren born preterm. Twenty-one children with bronchial obstruction, increased responsiveness to a beta2-agonist, and/or increased diurnal variation in peak expiratory flow (PEF) were selected for an open longitudinal study of the value of inhaled GC. None of these children had an earlier diagnosis of asthma or current GC treatment. Eighteen children with median (range) birth weight 1025 (640-1600) g and gestational age 28 (24-35) weeks, age at study 10.1 (7.7-13) years, were treated with inhaled budesonide in initially high (0.8 mg m(-2) day(-1) for 1 month) and subsequently lower dose (0.4 mg m(-2) day(-1) for 3 months). Daily symptom scores were recorded. Spirometric values were measured in the clinic at the beginning and end of each treatment period. At home, children used a data storage spirometer. After treatment with budesonide for 4 months, spirometric values in the clinic did not significantly change. The median forced expiratory volume in 1 sec (FEV1) was 74% of predicted both at entry and after budesonide treatment. However, the median number of > or = 20% diurnal change in PEF values at home decreased during treatment. According to the present study, inhaled budesonide for 4 months had no significant effect on basic lung function but may decrease bronchial lability in schoolchildren born preterm.