Budesonide improves decreased airway conductance in infants with respiratory symptoms

• Published in: Archives of disease in childhood 2009-07, Vol.94 (7), p.536-541
• Main Authors: Pelkonen, A S, Malmström, K, Malmberg, L P, Sarna, S, Turpeinen, M, Kajosaari, M, Haahtela, T, Mäkelä, M J
• Format: Article
• Language: English
• Subjects: Administration, Oral; Age groups; Airway Resistance - drug effects; Asthma; Biological and medical sciences; Body Weight; Bronchodilator Agents - therapeutic use; Budesonide; Budesonide - therapeutic use; Child, Preschool; Children; Corticoids; Cough - drug therapy; Diseases; Drug therapy; Dyspnea; Dyspnea - drug therapy; Female; Finland; General aspects; Glucocorticoids - therapeutic use; Health aspects; Hospitals; Humans; Infant; Infants; Lung - drug effects; Lung - physiology; Male; Measurement Techniques; Medical Evaluation; Medical sciences; Miscellaneous; Patient outcomes; Patients; Pediatric diseases; Physical Examinations; Pregnancy; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Respiratory function; Respiratory Sounds - drug effects; Respiratory tract diseases; Skin; Steroids; Terbutaline - therapeutic use; Treatment Outcome; Young Children
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.2007.132100

Objective:Inhaled corticosteroids (ICS) are commonly used to treat wheezing disorders in children, but few studies have investigated the effect of ICS on lung function in infants. We evaluated the efficacy of inhaled budesonide for decreased specific airway conductance (sGaw) as an indication of bronchial obstruction in very young children with recurrent cough and/or wheeze.Patients, design and interventions:Functional residual capacity (FRC) and sGaw of steroid-naive children aged 3–26 months with respiratory symptoms were measured using an infant whole-body plethysmograph. Clinically indicated bronchoscopy was performed in 79% of the patients to exclude anatomical abnormalities before randomisation. Children with abnormal lung function and respiratory symptoms were randomised into two treatment groups, receiving either inhaled budesonide (400 μg/day) or placebo with NebuChamber for 6 weeks. Inhaled terbutaline 0.25 mg/dose was used as a rescue medication. Lung function measurements were repeated after 6 weeks.Main outcome measure:Lung function.Results:44 children with a median age of 11.3 months (range 3.7–25.9) completed the study. Median sGaw improved from a z score of −3.6 to −1.2 (p