Budesonide and terbutaline or terbutaline alone in children with mild asthma: effects on bronchial hyperresponsiveness and diurnal variation in peak flow.

Abstract

The effects of treatment with budesonide (200 pg twice daily) and terbutaline (500 pg four times daily) has been compared with the effects of placebo and terbutaline in 27 children with mild asthma, aged 7-14 years, in a double blind, randomised placebo controlled study over eight weeks. Bronchial responsiveness (PC20 histamine), lung function, the amplitude of diurnal variation in peak expiratory flow (PEF), and symptom scores were measured. Baseline FEV, was over 70% predicted and PC20 histamine less than 8 mg/ml. Twelve children were treated with budesonide and terbutaline and 15 with placebo and terbutaline. After four and eight weeks of treatment the change in PC20 was significantly greater after budesonide and terbutaline than after terbutaline alone by 2-1 (95% CI 0-5-3 8) and 1-3 (95% CI 0-1-2-5) doubling doses respectively. Mean FEV, did not change in either group. The change in afternoon and nocturnal PEF was significantly greater after budesonide and terbutaline than after terbutaline alone. The amplitude of diurnal variation in PEF did not change significantly in either group. Peak flow reversibility decreased in the budesonide group. There were no differences between treatments for cough and dyspnoea, but wheeze improved in the budesonide group. The children with mild asthma treated with budesonide and terbutaline showed improvement in bronchial responsiveness, afternoon and nocturnal PEF, and symptoms of wheeze and a fall in peak flow reversibility by comparison with those who received terbutaline alone.

Clinical efficacy of low-dose inhaled budesonide once or twice daily in children with mild asthma not previously treated with steroids

“…WAALKENS et al [19] compared the effects of treatment with budesonide 200 µg twice daily and terbutaline with the effects of terbutaline alone in a placebo-controlled, double-blind study in 27 children with mild asthma (FEV1 93% pred) over 8 weeks. They found that mean FEV1 did not change in either group and that there was no significant change in morning PEF, although they found a significant difference in favour of BUD for evening and nocturnal PEF.…”

Tolerance with beta 2‐adrenoceptor agonists: time for reappraisal.

“…Furthermore these effects were maintained over the 24 months of follow-up ( Figure 3). In a smaller study of 27 asthmatic children, the combination of budesonide (400 jg daily) and terbutaline (2000 jg daily) produced a reduction in histamine reactivity with a 2.1 doubling dose difference compared with terbutaline plus placebo [25]. [40,41].…”

Children with mild asthma: do they benefit from inhaled corticosteroids?

“…Until now only a few studies have evaluated the effect of ICS in children with mild asthma [9][10][11][12][13]. Most of these studies were performed in older children and using different effect parameters.…”

“…There have only been a few studies concerning the short- [9,10] or long-term effects [11] of ICS in children with mild asthma. Placebo controlled studies are especially rare [12][13][14].…”