| The effect of 6 weeks of treatment with inhaled budesonide on bronc-hial hyperresponsiveness and adrenal function in asthmatic patients. |
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Kwan Hyoung Kim, Yong Seok Oh, Chi Hong Kim, Soon Seong Kwon, Young Kyoon Kim, Ki Don Han, Hwa Sik Moon, Jeong Sup Song, Sung Hak Park |
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Department of Internal Medicine, Catholic University Medical College, Seoul, Korea |
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| Abstract |
Background
Acute and chronic airway inflammation are important in the pathogenesis of bronchial asthma. Corticosteroids have proved to be very effective in the management of asthma.
Although the mechanism by which they produce this effect is still debated, suppression of the inflammatory response is thought to be the most likely. Although inhaled steroids are known to be safe and have less side effects than oral steroids, the extent which inhaled steroids have beneficial and the detrimental effects in the treatment of asthma has remained open to question. Budesonide is a recently developed corticosteroid for inhalation treatment with a strong local effect combined with rapid inactivation in the systemic circulation.
We set out to look in more detail at the time course of change in bronchial reactivity, clinical symptoms and the effects on the adrenal function during 6 weeks of treatment with budesonide (800 ug per day).
Methods
Clinical symptoms, pulmonary function test, histamine PC20 serum ACTH and cortisol (8 AM and 4 PM) were measured in 23 allergic asthmatic patients before and after 6 weeks of treatment with budesonide.
Results
1) Pulmonary function test; PEFR, FEVl and FVC after 6 weeks of treatment with budesonide were higher than those before treatment.
2) Clinical symptoms; Clinical symptoms were significantly improved after 3 weeks and 6 weeks of treatment with budesonide.
3) Histamine provocation; Histamine PC20 after 6 weeks of treatment with budesonide was significantly higher than that before treatment.
4) Adrenal function; 6 weeks of budesonide therapy did not significantly affect the level of serum ACTH and cortisol.
Conclusion
From these results, it is concluded that budesonide therapy improved the clinical symptoms, pulmonary function and bronchial hyperreactivity after 3 weeks of treatment and the improvement after 6 weeks of treatment was higher than that after 3 weeks of treatment. During 6 weeks of treatment with budesonide, the inhibitory effect on the adrenal function was not obvious. |
| Key Words:
Asthma, Budesonide, Treatment, Adrenal Function |
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