Nebulized Fluticasone Propionate vs. Budesonide as Adjunctive Treatment in Children with Asthma Exacerbation

Benedictis, Fernando Maria de; Giudice, Michele Miraglia Del; Vetrella, M; Tressanti, Flaviana; Tronci, Alessandro; Testi, Rossana; Dašić, Gorana; FLIC, On Behalf of; Group, Study

doi:10.1081/jas-200062966

Cited by 18 publications

(8 citation statements)

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“…In the present study, a longer post-treatment effect was reported under budesonide intervention as compared to fluticasone treatment (P<0.0001). This result was not in line with that of a previous study (11). A possible explanation for this discrepancy is that in the present study, a step-down approach was adopted in the intervention, which improved the effectiveness of budesonide (21).…”

Section: Discussioncontrasting

confidence: 99%

“…After 3 months of treatment, budesonide and fluticasone nebulization were proven effective in improvement of sRaw and FEV1 values and no adverse effects on adrenal function were observed. The study results regarding budesonide were similar to those of previous studies (5,10,11,17) but results regarding fluticasone were not in accordance with a previous study (3). Budesonide (19) and fluticasone (10) have potent airway anti-inflammatory action.…”

Section: Discussionsupporting

confidence: 63%

“…The effects reported for budesonide are similar to those of all inhaled corticosteroids, while the inhibition of histamine release from mast cells by fluticasone is not proven. In general, inhaled corticosteroids are not able to prevent immediate airway responses to allergens (only after long-term treatment), the major cause of which is mast cell degranulation (11).…”

Section: Introductionmentioning

confidence: 99%

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Nebulized step‑down budesonide vs. fluticasone in infantile asthma: A retrospective cohort study

Bian

Hui

et al. 2019

Exp Ther Med

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The United States Food and Drug Administration has approved budesonide in infantile asthma but nebulization of infants under budesonide has the risk of relapse of asthma. The objective of the present study was to compare the effectiveness and safety of fluticasone step-down treatment with budesonide step-down treatment in infantile asthma. The data of 778 infants with confirmed asthma were included in the analysis. Infants who had received nebulized 500 µg budesonide twice daily for 6 weeks followed by 250 µg budesonide twice daily for 6 weeks were included in the BS group (n=389), while infants who had received nebulized 250 µg fluticasone twice daily for 6 weeks followed by 125 µg fluticasone twice daily for 6 weeks were included in the FC group (n=389). The data of lung function tests and a safety study were collected and analyzed. Budesonide treatment achieved a reduced specific airway resistance (sRaw; 1.28±0.11 vs. 1.21±0.10 kPa/sec; P<0.0001, q=13.45) and improved forced expiratory volume in 1 sec (FEV1; 0.977±0.068 vs. 0.997±0.085 l/sec; P<0.0001, q=5.54). In addition, fluticasone treatment achieved a reduced sRaw (1.27±0.1 vs. 1.23±0.11 kPa/sec, P<0.0001, q=7.39) and improved FEV1 (0.971±0.069 vs. 0.992±0.085 l/sec; P=0.0003, q=5.46). Of note, the efficacy of budesonide to reduce sRaw (P=0.008, q=3.69) and improve FEV1 (P<0.0001, q=6.93) was greater than that of fluticasone. The budesonide treatment group had more post-treatment symptom-free days than the fluticasone treatment group (165.56±23.15 vs. 112.21±9.45 days; P<0.0001). The step-down approach of budesonide nebulization may better support the functional and clinical outcomes with an increased number of post-treatment symptom-free days compared with fluticasone in infantile asthma (level of evidence, 3).

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

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Nebulized step‑down budesonide vs. fluticasone in infantile asthma: A retrospective cohort study

Bian

Hui

et al. 2019

Exp Ther Med

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“…Volovitz B and colleagues reported that high dose of inhaled budesonide was not associated with a decrease in cortisol plasma concentration [27]. De Benedictis and colleagues reported that 10 days of administration of 500 mcg nebulized budesonide or 250 mcg fluticasone was not associated with hypophysial pituitary axis suppression [28].…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Effectiveness of Budesonide Inhalation in Reducing Postoperative Throat Complaints

Chen¹

2012

J Anesthe Clinic Res

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Objective: To evaluate the efficacy of budesonide suspension inhalation in reducing the incidence and severity of postoperative sore throat (POST) and hoarseness induced by tracheal intubation.Methods: 120 patients scheduled for thyroid surgery with general anaesthesia were randomized into 3 groups. Group A received 200 mcg budesonide inhalation suspension (BIS) 10 min prior to the tracheal intubation and received the same treatment 6 h and 24 h after extubation. Group B received 200 mcg BIS 6 h and 24 h after extubation. Control group received the same scheduled treatment as Group A, but the BIS was replaced with 2 ml normal saline. The patients were evaluated for POST and hoarseness 1, 24 and 48h after extubation and the status of laryngopharynx was examined and recorded as well. Results:The incidences of post-operation complaints in three groups were 72.5%, 82.5% and 87.55% for POST, and 37.3%, 52.5% and 75% for hoarseness, respectively. There was no statistically significant difference in the incidence of POST between three groups. However, hoarseness occurred significantly less frequently in Group A in comparison to Group B and control group (P<0.05). One hour post extubation, Group A exhibited significantly less severe POST and hoarseness compared to the other two groups (P<0.05), which disappeared 24 h later. One hour after extubation both VAS scores of POST and hoarseness were significantly lower in Group A than those in the other two groups (P<0.05). The mucositis scores of laryngopharynx at 1,24 and 48 h post extubation were significantly lower in Group A compared to the other two groups (P<0.05). Conclusions:The prophylactic use of inhaled budesonide suspension significantly decreases the incidence and severity of sore throat and hoarseness after tracheal intubation. J o u rn al of A n e s th es ia & C li n ic a l Resea rc h

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“…BUD solution is so far the only Food and Drug Administration (FDA)‐approved nebulized ICS for children. However, the efficacy of nebulized BUD in the treatment of acute exacerbation of asthma has been addressed only in a very limited number of randomized, double‐blind, placebo‐controlled studies . In one study, Devidayal et al .…”

Section: Discussionmentioning

confidence: 99%

Effects of nebulized high‐dose budesonide on moderate‐to‐severe acute exacerbation of asthma in children: A randomized, double‐blind, placebo‐controlled study

et al. 2013

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Background and objective: The efficacy of inhaled corticosteroids (ICS) in asthma exacerbation are yet to be clarified. The aim of this study was to investigate the efficacy of nebulized ICS in children with moderate-tosevere acute exacerbation of asthma in an emergency room setting in order to elucidate the potential use of ICS as the first-line therapy in the management of acute exacerbation of asthma. Methods: This was a prospective, randomized, double-blind, placebo-controlled study. Paediatric patients with moderate-to-severe acute exacerbation of asthma in emergency room were randomized to receive nebulized salbutamol and ipratropium bromide, with the addition of nebulized high-dose budesonide (BUD group, n = 60) or normal saline (control group, n = 58), three doses in the first hour. Results: The improvement in forced expiratory volume in 1 s was similar in both groups at 0 h after three doses of nebulization, but there was significantly further improvement at 1 and 2 h in the BUD group (0.095 ± 0.062 L and 0.100 ± 0.120 L, respectively) compared with the control group (0.059 ± 0.082 L and 0.021 ± 0.128 L, respectively), P = 0.013 and 0.001, respectively. Complete remission rate was significantly higher (84.7% vs 46.3%, P = 0.004) and need for oral corticosteroids was significantly lower (16.9% vs 46.3%, P = 0.011) in BUD group than in control group. Conclusion: On the basis of nebulized short-acting bronchodilators, addition of nebulized high-dose budesonide resulted in clinical improvement in children with moderate-to-severe acute exacerbation of asthma, suggesting that nebulized high-dose ICS can be used as first-line therapy for non-life-threatening acute exacerbation of asthma in children.

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Nebulized Fluticasone Propionate vs. Budesonide as Adjunctive Treatment in Children with Asthma Exacerbation

Cited by 18 publications

References 0 publications

Nebulized step‑down budesonide vs. fluticasone in infantile asthma: A retrospective cohort study

Nebulized step‑down budesonide vs. fluticasone in infantile asthma: A retrospective cohort study

Prophylactic Effectiveness of Budesonide Inhalation in Reducing Postoperative Throat Complaints

Effects of nebulized high‐dose budesonide on moderate‐to‐severe acute exacerbation of asthma in children: A randomized, double‐blind, placebo‐controlled study

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