0
Articles |

Oral Glucocorticosteroid-Sparing Effect of Budesonide Administered by Turbuhaler : A Double-blind, Placebo-Controlled Study in Adults With Moderate-to-Severe Chronic Asthma

Harold S. Nelson; I. Leonard Bernstein; Jordan Fink; Thomas B. Edwards; Sheldon L. Spector; William W. Storms; Donald P. Tashkin; Pulmicort Turbuhaler Study Group
Author and Funding Information

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles


Affiliations: From the Department of Medicine, National Jewish Medical and Research Center, Denver,  From the the Allergy-Group, Inc, Cincinnati,  From the Allergy Associates, Milwaukee,  From the Allergy and Asthma Center of Albany Medical College, Albany, NY,  From the Allergy Research Foundation, Los Angeles,  From The Research Center Allergy Associates, Colorado Springs, Colo,  From the UCLA School of Medicine, Los Angeles

1998 by the American College of Chest Physicians


Chest. 1998;113(5):1264-1271. doi:10.1378/chest.113.5.1264
Text Size: A A A
Published online

Abstract

Objective: To determine the ability of budesonide via an inhaler (Pulmicort Turbuhaler; Astra Draco AB) to replace oral glucocorticosteroids (GCSs) in adult subjects with moderate-to-severe asthma.

Design: Double-blind, randomized, and placebo-controlled study, with parallel groups.

Setting: Multicenter study in outpatient setting.

Participants: Eighty men and 79 women, aged 20 to 69 years, with moderate-to-severe asthma and a mean FEV1 of 58.3% predicted normal. All subjects were receiving oral GCS treatment and 79% of subjects were also receiving inhaled beclomethasone dipropionate (BDP). The mean daily doses of prednisone at baseline, including converted dose of BDP, for the placebo, budesonide 400 µg, and budesonide 800 µg, respectively, were 19.7 mg, 19.5 mg, and 18.7 mg.

Measurements and interventions: After a 2-week baseline period, subjects entered a 20-week treatment period, during which the oral dose of prednisone was reduced by forced down-titration at 2-weekly intervals.

Results: Subjects receiving 400 µg or 800 µg bid of budesonide achieved a significantly greater reduction (82.9% and 79.0% respectively) in oral GCS dose compared with placebo-treated subjects (27%; p<0.001). Two thirds of the subjects receiving budesonide were able to achieve sustained oral corticosteroid cessation, compared with 8% in the placebo group. Additionally, both doses of budesonide resulted in significant improvement in results of pulmonary function tests and asthma symptoms scores, and a significant decrease in the use of bronchodilator therapy. The mean plasma cortisol levels before and after adrenocorticotropic hormone stimulation increased most toward the normal range in the budesonide-treated groups compared with placebo-treated subjects.

Conclusion: Budesonide administered via Turbuhaler has a significant oral GCS-sparing capacity with maintained or improved asthma control in adult subjects with moderate-to-severe asthma.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
[Attention to acceptance and adherence]. MMW Fortschr Med 2016;158(10):90.
[Role of ICS/LABA on COPD treatment]. Nihon Rinsho 2016;74(5):827-32.
Guidelines
Rheumatoid arthritis. The management of rheumatoid arthritis in adults.
National Clinical Guideline Centre for Acute and Chronic Conditions | 9/18/2009
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543