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document
Comparison of high and low dose of the inhaled steroid , budesonide , as an initial treatment in newly detected asthma . The importance of early initiation of inhaled steroids even in mild asthma has been documented in several studies . It is not , however , clear whether the treatment should be started with a high or a low dose of the inhaled steroid . We have compared the effects of high and low dose inhaled steroid , budesonide , in patients with newly detected asthma . We studied 101 adult patients with newly detected bronchial asthma who were without inhaled steroid or any regular pharmacological treatment for their asthma . The patients were randomly allocated to two treatment groups : one to receive 800 microg inhaled budesonide per day and the other to receive 200 microg inhaled budesonide per day . The drugs were given with a Turbuhaler dry powder inhaler . During the 3-month treatment period , no significant differences between the treatment groups were noted in morning or evening PEF values , in spirometric parameters , in asthmatic symptoms or in the use of rescue beta2-agonists . The decrease in bronchial hyperresponsiveness was , however , more marked in the high dose budesonide group , reaching a borderline significance ( P=0.10 high vs. low dose budesonide ) . In addition , in serum markers of asthmatic inflammation significant differences were shown between the treatment groups . The decrease in the number of blood eosinophils during the treatment was more marked in the high dose budesonide group ( P=0.02 ; high vs. low dose budesonide ) . In serum ECP no change was observed in the low dose budesonide group , but a marked decrease in the high-dose budesonide group ( P=0.008 ; high vs. low dose budesonide ) . The change was even more marked with regard to serum EPX ( P=0.005 ; high vs. low dose budesonide ) . Our results support the view that the treatment of newly detected asthma should be started with a high dose of inhaled steroid . The low dose may not be enough to suppress asthmatic inflammation despite good clinical primary response .
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Intervention_Pharmacological
inhaled steroid , budesonide
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Intervention_Pharmacological
inhaled steroids
3948
Intervention_Pharmacological
high and low dose inhaled steroid
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Intervention_Pharmacological
budesonide
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Intervention_Pharmacological
800 microg inhaled budesonide
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Intervention_Pharmacological
200 microg inhaled budesonide
3952
Intervention_Pharmacological
Turbuhaler dry powder inhaler
3953
Intervention_Pharmacological
budesonide
3954
Intervention_Pharmacological
budesonide
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Outcome_Physical
morning or evening PEF values
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Outcome_Physical
decrease in bronchial hyperresponsiveness
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Outcome_Other
more marked
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Outcome_Physical
serum markers of asthmatic inflammation
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Outcome_Physical
decrease in the number of blood eosinophils
3960
Outcome_Other
more marked
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Outcome_Physical
serum ECP
3962
Outcome_Other
marked
3963
Outcome_Physical
regard to serum EPX
3964
Participant_Condition
asthma
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Participant_Condition
asthma
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Participant_Sample-size
101 adult patients
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Participant_Condition
bronchial asthma
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Participant_Condition
inhaled steroid
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Participant_Condition
pharmacological treatment
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Participant_Condition
asthma