PURPOSE: This study was undertaken to compare the efficacy of inhaled salbutamol and inhaled procaterol in the management of mild and moderate asthma exacerbation.
METHODS: This is a parallel, single blind randomized controlled clinical trial conducted to 32 children. Treatment was allocated randomly. Group 1 received 2 puffs of salbutamol (200 ug) while group 2 received 1 puff of procaterol (10 ug). These were administered every 20 minutes for 3 doses. Peak expiratory flow rate (PEFR), Modified Wood Downes’ (MWD) Clinical Asthma Score, heart rate and cardiac rate were reassessed at 20, 40, 60, 90, 120, 180, 240 and 300 minutes. Mean percent predicted PEFR and mean percent change in PEFR from baseline were computed. Outcome of each patient either discharged or requiring further treatment and adverse effects were determined.
RESULTS: The mean percent predicted PEFR and mean percent change in PEFR significantly increased in both groups (p<0.0001) over time. There was no significant difference between the 2 groups in mean percent predicted PEFR and mean percent change in PEFR at 0 to 240 minutes (p>0.05). At 300 minutes, these parameters decreased in group 1 while that in group 2 continued to increase. The MWD Asthma Scores in group 2 decreased at 240 and 300 minutes (p=0.032 and p=0.017, respectively) signifying improvement. Six patients (37.5%) required further treatment in the salbutamol group while 2 patients (12.5%) needed additional therapy in the procaterol group. However, this difference was not statistically significant. Adverse effects were not observed in both groups.
CONCLUSION: This study showed that inhaled salbutamol and inhaled procaterol were both efficacious in the management of mild to moderate exacerbation. A sustained and prolonged bronchodilator response was noted using procaterol.
CLINICAL IMPLICATIONS: The initial management of mild to moderate asthma exacerbation includes administration of inhaled short-acting bronchodilator(SABA). At present, the long-acting bronchodilator (LABA) is recommended for use as “symptom controller“. This study showed that inhaled procaterol, a LABA, is as efficacious as salbutamol, a SABA, and has a sustained bronchodilatory action.
DISCLOSURE: Olivia Cristina Go, No Financial Disclosure Information; No Product/Research Disclosure Information