Comparing Budesonide and Fluticasone Propionate in Children with Moderate to Severe Asthma: A Pilot Randomized...

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Clinical Pharmacology

Background:

• Asthma management in children requires effective anti-inflammatory strategies.
• Inhaled corticosteroids (ICS) are foundational therapies for persistent asthma.
• Comparing the efficacy of different ICS is crucial for optimizing treatment.

Purpose of the Study:

• To compare the efficacy of fluticasone propionate (FP) and budesonide (Bud) in children with moderate to severe asthma.
• To evaluate the impact of FP versus Bud on asthma control, clinical symptoms, and rescue medication use.
• To assess treatment outcomes over a 3-month period in pediatric asthma patients.

Main Methods:

• An open-label study involving 50 children (ages 4-7) with moderate to severe asthma.
• Randomized assignment to receive either FP 250 mcg or Bud 400 mcg daily for 3 months.
• Monthly assessment of Asthma Control Test (ACT) scores, clinical symptoms, drug adherence, and rescue inhaler use.

Main Results:

• Both FP and Bud groups showed significant improvements in ACT scores, nocturnal symptoms, and cough rates.
• The fluticasone propionate group achieved higher average ACT scores (24.84±2.67 by month 3) compared to the budesonide group (22.48±4.12).
• Fluticasone propionate significantly reduced the need for salbutamol (rescue medication) compared to budesonide throughout the study period.

Conclusions:

• Fluticasone propionate (250 mcg) is more effective than budesonide (400 mcg) in improving asthma control and reducing rescue medication needs in children with moderate to severe asthma.
• FP demonstrated superior efficacy in enhancing asthma control test scores and decreasing salbutamol use.
• These findings suggest FP may be a preferred treatment option for optimizing asthma management in this pediatric population.