High Dose Inhaled Budesonide in the Treatment of Severe Steroid‐Dependent Asthmatics

Publisher Website
Google Scholar
Abstract
Patients (38) with chronic asthma requiring continuous oral corticosteroid treatment took part in a 2-yr study. Budesonide, a new inhalation steroid with high topical activity and low systemic effects, was given in stepwise increasing doses from 200 .mu.g daily up to 800-1600 .mu.g daily and prednisolone doses were decreased gradually on an individual basis. After 2 yr, 18 patients had been able to cease oral prednisolone treatment, 11 had decreased the dose by .gtoreq. 50%, 3 by .ltoreq. 50% and 2 patients had increased their dose. At the end of the study the majority of patients (26) were using 800 .mu.g budesonide daily and 7, 2 1200 .mu.g daily. There were 2 dropouts, 1 due to local side effects and 1 to a severe pulmonary eosinophilia. Ten patients had local side effects in the form of hoarseness and/or sore throat, and 13 patients had steroid withdrawal symptoms such as arthralgia and myalgia. The asthma condition in all patients was improved, as indicated by the reduced need for hospital admissions. The results indicate that high doses of budesonide should be tried before starting maintenance therapy with oral steroids.