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A comparison of inhaled budesonide and beclomethasone dipropionate in childhood asthma
1Department of Pneumology, Hôpital Universitaire Erasme, Brussels, Belgium.
Insights
Budesonide and beclomethasone dipropionate (BDP) improved asthma control in children. Budesonide demonstrated superior efficacy in enhancing peak expiratory flow rates (PEFR) and forced expiratory volume in 1 second (FEV1.0) compared to BDP.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Clinical Medicine
Background:
- Asthma management in children often relies on inhaled corticosteroids (ICS).
- Comparing the clinical efficacy of different ICS is crucial for optimizing treatment.
- Beclomethasone dipropionate (BDP) and budesonide are commonly prescribed ICS.
Purpose of the Study:
- To compare the clinical effects of beclomethasone dipropionate (BDP) and budesonide in children with asthma.
- To evaluate the efficacy of these inhaled corticosteroids administered via different devices.
- To assess the impact on lung function and safety parameters.
Main Methods:
- A double-blind, randomized, cross-over trial involving 21 children (4-14 years) with regular ICS use.
- Each treatment period (BDP, budesonide, placebo) lasted 3 weeks with a dosage of 100 micrograms twice daily.
- Budesonide was administered via a spacer inhaler (Inhalet), and BDP via a standard actuator.
Main Results:
- Both budesonide and BDP significantly improved morning and evening PEFR compared to placebo.
- Budesonide showed significantly higher morning and/or evening peak flows than BDP.
- FEV1.0 significantly improved with budesonide but not with BDP compared to placebo.
- No significant adverse effects, including Candida infections, were observed.
- Asthma control deteriorated during the placebo period, confirming steroid dependence.
Conclusions:
- Budesonide demonstrates superior efficacy over beclomethasone dipropionate in improving lung function (PEFR and FEV1.0) in asthmatic children.
- Both ICS are effective in managing childhood asthma, but budesonide may offer better control.
- Further research could explore optimal device-drug combinations for pediatric asthma therapy.
Abstract:
The objective of this study was to compare the clinical effects of beclomethasone dipropionate (BDP) and budesonide in asthmatic children using two common ways of administration. Twenty-one children, aged 4-14 years, who regularly used inhaled corticosteroids for their control of asthma were included in the study. The drugs were studied by using a double-blind randomized cross-over design trial with a single-blind placebo period at the end. Each period lasted 3 weeks. The dosage was 100 micrograms b.i.d. for both drugs. Budesonide was administered via a spacer inhaler (Inhalet), and beclomethasone dipropionate via a standard actuator. Compared with placebo, both drugs significantly improved PEFR values for morning (20% for budesonide and 14% for BDP) and evening (14% for budesonide and 9% for BDP). Both morning and/or evening peak flows were significantly higher during the budesonide treatment as compared with the BDP treatment. In comparison with the placebo period, FEV1.0 was significantly improved with budesonide but not with BDP. Plasma cortisol, WBC counts, differential and eosinophilia counts in blood were determined at the beginning and the end of each period. All of the values except for the eosinophil counts were within normal ranges. Candida was looked for but not found in any case. No other adverse effects were registered. For most of the children, a deterioration of the state of their asthma and increased need for concomitant therapy during the placebo period confirmed their steroid dependence. The number of administrations with concomitant anti-asthmatic therapy increased during placebo by 61% as compared with the budesonide therapy, and by 40% compared with the BDP therapy.