This double-blind study aimed to determine whether superior asthma control is achieved with budesonide (Pulmicort® Turbohaler®) at a loading dose (LD) (400 I..Ig b.d. ) for 6 weeks, followed by step down to 400 I..Ig nocte for 12 weeks, compared with a static dose (SO) (400 I..Ig nocte) for 18 weeks. A total of 682 patients (mean peak expiratory flow rate (PEFR) 413 I/min), who demonstrated ｾ 15% reversibility in PEFR, were randomised into the study. After 18 weeks, patients experienced improvements in morning PEFR (+45 I/min, both groups), symptom score (LO -0.57, SO -0.49, on a scale of 0-3), sleep disturbance (LO -1.21 nights/week, SO -1.06 nights/week) and ｾ Ｒ Ｍ ｡ ｧ ｯ ｮ ｩ ｳ ｴ use (LO -1.36 puffs/day, SO -1.06 puffs/day), within both groups (each p=0.0001). At 18 weeks, 82% (LO) and 84% (SO) of patients benefited from no nocturnal wakening in the previous 7 days. Overall" at 18 weeks, asthma control was not significantly different between the groups. After 6 weeks, improvements in morning PEFR (LO +361/min, SO +26I/min) and ｾ Ｒ Ｍ ｡ ｧ ｯ ｮ ｩ ｳ ｴ use (LO -1.10 puffs/day, SO -0.94 puffs/day) were greater in the loading dose than in the static dose group (each p<0.05). The greater improvement in morning PEFR in the loading dose group was significant by day 7 (p<0.05). While both regimens are equally effective in achieving asthma control at 18 weeks, early clinical advantage is gained with initial loading dose budesonide (400 I..Ig b.d.).