Inhaled Budesonide vis-à-vis Inhaled Mometasone in Chinese Children with Mild Persistent Asthma: A Single-Center, Retrospective Study

Pharmacology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Pei Gao ◽  
Ying Ding ◽  
Bingru Yin ◽  
Haoxiang Gu
Keyword(s):  
Retrospective Study ◽  
Asthma Exacerbation ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
Forced Expiratory Volume ◽  
Single Center ◽  
Level Of Evidence ◽  
Asthmatic Children ◽  
Technical Efficacy ◽  
Mild Persistent Asthma

<b><i>Introduction:</i></b> A very limited option of inhaled corticosteroids (ICSs) is approved for pediatric use in China because in children the use of ICSs for long periods is associated with dose-dependent growth reduction. Due to the lack of consensus on which is the best ICS-based treatment option to manage mild persistent asthma in children, the present study was performed to evaluate the efficacy and safety of budesonide (BUD)-based therapy vis-à-vis mometasone-based therapy in children with mild persistent asthma. <b><i>Methods:</i></b> A single-center, retrospective study was conducted in asthmatic children aged between 6 and 11 years. BUD and mometasone furoate (MF) were administered as per the approved dosing regimen using pressurized metered-dose inhalers via oral inhalation route for a period of 12 weeks. The study outcome was assessed in terms of the forced expiratory volume in 1 s (FEV<sub>1</sub>), symptom scores, and nonoccurrence of side effects. <b><i>Results:</i></b> Among the 77 asthmatic children, 71 completed the study treatment and were used in carrying out the analysis. The improvement of spirometric parameters like FEV<sub>1</sub>, Tiffeneau-Pinelli index (FEV1/forced vital capacity [FVC]), and peak expiratory flow (PEF) values observed in the MF cohort was significantly greater than those of the BUD cohort (<i>p</i> &#x3c; 0.05 for all). An increase of approximately 12%/child was observed for FEV<sub>1</sub>/FVC ratios for the BUD cohort and MF cohorts. After the 12-week study, the PEF<sub>m</sub> and PEF<sub>e</sub> values increased to about 50 L/min/child for the BUD cohort and about 98 L/min/child for the MF cohort. During the study, no asthma exacerbation event was observed in the MF cohort, whereas 1 child in the BUD cohort had asthma exacerbation in week 4. The use of rescue medication during the study was required for 16.2 and 6% of children, respectively, for BUD and MF cohorts. Owing to low dosing frequency, MF could provide a better treatment approach than BUD due to improved patient compliance. <b><i>Conclusions:</i></b> Although both drugs showed improvement in the quality of life of asthmatic children with manageable treatment-emergent adverse effects, the improvement was augmented in MF-treated children. <b><i>Level of Evidence:</i></b> The level of evidence was III. <b><i>Technical Efficacy Stage:</i></b> The technical efficacy stage was 4.

scholarly journals Rapid improvement of respiratory quality in asthmatic children after "assisted drainage" therapy

2010 ◽  
Vol 50 (4) ◽  
pp. 199
Author(s):  
Haryono Utomo ◽  
Ariyanto Harsono
Keyword(s):  
Asthma Management ◽  
Persistent Asthma ◽  
Forced Expiratory Volume ◽  
Rapid Improvement ◽  
Test Analysis ◽  
Asthmatic Children ◽  
Focal Infection ◽  
Dental Practitioners ◽  
Asthma Patients ◽  
Mild Persistent Asthma

Background  Whilst current asthma management is well-developed, there are still 5-10% uncontrolled asthma patients with unknown etiologies. However, its connection with oral focal infection is still uncertain. Therefore, a collaborated research for asthma management was conducted by pediatricians and dental practitioners. Within minutes after the "assisted drainage" therapy, a modification of healing root planning procedure, there is rapid improvement of respiratory function, ie., forced expiratory-volume one second (FEV1) in asthmatic children. This quick response usually achieved by oral inhalation.Objective To investigate the effectiveness of the assisted drainage therapy in the improvement of respiratory quality.Methods Fifteen asthmatic children were subjected to a longitudinal study for two weeks. In tbe first week they were instructed for al lergen avoidance only and the fOllowing one week was combined with tbe assisted drainage therapy, followed by  mental health education and dental plaque control therapy. Each s'ubject was af'sef'sed for respiratory quality with a computerized spirometer and blood sampling test. Paired t-test analysis was used for statistical analysis.Results Assisted drainage therapy was performed, within minutes FEV1 increased significantly (P= 0.001). Additionally, there were significant differences serum histamine (P= 0,001) pre and post treatment.Conclusions The assisted drainage therapy is effective as an adjuvant therapy for mild persistent asthma in children.

scholarly journals Swimming and Persons with Mild Persistant Asthma

2007 ◽  
Vol 7 ◽  
pp. 1182-1188 ◽  
Author(s):  
Mirjana Arandelovic ◽  
Ivana Stankovic ◽  
Maja Nikolic
Keyword(s):  
Lung Function ◽  
Inhaled Corticosteroids ◽  
Bronchial Hyperresponsiveness ◽  
Persistent Asthma ◽  
Forced Expiratory Volume ◽  
Control Group ◽  
Significant Difference ◽  
Group A ◽  
Mild Persistent Asthma ◽  
Group B

The aim of our study was to analyze the effect of recreational swimming on lung function and bronchial hyperresponsiveness (BHR) in patients with mild persistent asthma. This study included 65 patients with mild persistent asthma, who were divided into two groups: experimental group A (n = 45) and control group B (n = 20). Patients from both groups were treated with low doses of inhaled corticosteroids (ICS) and short-acting β2 agonists salbutamol as needed. Our program for patients in group A was combined asthma education with swimming (twice a week on a 1-h basis for the following 6 months). At the end of the study, in Group A, we found a statistically significant increase of lung function parameters FEV1 (forced expiratory volume in 1 sec) (3.55 vs. 3.65) (p < 0.01), FVC (forced vital capacity) (4.27 vs. 4.37) (p < 0.05), PEF (peak expiratory flow) (7.08 vs. 7.46) (p < 0.01), and statistically significant decrease of BHR (PD200.58 vs. 2.01) (p < 0.001). In Group B, there was a statistically significant improvement of FEV1 3.29 vs. 3.33 (p < 0.05) and although FVC, FEV1/FVC, and PEF were improved, it was not significant. When Groups A and B were compared at the end of the study, there was a statistically significant difference of FVC (4.01 vs. 4.37), FEV1 (3.33 vs. 3.55), PEF (6.79 vs.7.46), and variability (p <0.001), and statistically significantly decreased BHR in Group A (2.01 vs. 1.75) (p < 0.001). Engagement of patients with mild persistent asthma in recreational swimming in nonchlorinated pools, combined with regular medical treatment and education, leads to better improvement of their parameters of lung function and also to more significant decrease of their airway hyperresponsiveness compared to patients treated with traditional medicine

scholarly journals Montelukast versus inhaled corticosteroids in the management of pediatric mild persistent asthma

2012 ◽  
Vol 7 ◽  
Author(s):  
Alessandra Scaparrotta ◽  
Sabrina Di Pillo ◽  
Marina Attanasi ◽  
Daniele Rapino ◽  
Anna Cingolani ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
Jadad Score ◽  
First Line ◽  
Poor Growth ◽  
Asthmatic Children ◽  
Randomized Controlled ◽  
Pediatric Populations ◽  
Leukotriene Receptor ◽  
Mild Persistent Asthma

International guidelines recommend the use of inhaled corticosteroids (ICSs) as the preferred therapy, with leukotriene receptor antagonists (LTRAs) as an alternative, for the management of persistent asthma in children. Montelukast (MLK) is the first LTRA approved by the Food and Drug Administration for the use in young asthmatic children. Therefore, we performed an analysis of studies that compared the efficacy of MLK versus ICSs. We considered eligible for the inclusion randomized, controlled trials on pediatric populations with Jadad score>3, with at least 4 weeks of treatment with MLK compared with ICS. Although it is important to recognize that ICSs use is currently the recommended first-line treatment for asthmatic children, MLK can have consistent benefits in controlling asthmatic symptoms and may be an alternative in children unable to use ICSs or suffering from poor growth. On the contrary, low pulmonary function and/or high allergic inflammatory markers require the corticosteroid use.

scholarly journals Inhaled corticosteroids and leukotriene modifiers as mono-therapy for mild persistent asthma

2013 ◽  
Vol 62 (3) ◽  
pp. 363-369
Author(s):  
Amr Radwan ◽  
Hoda Abd El-Aziz Salem ◽  
Mohamed E.A. Abdelrahim ◽  
Amgad A. Farhat ◽  
Ghada Atef Attia
Keyword(s):  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
Mild Persistent Asthma

scholarly journals Association among Fraction of Exhaled Nitrous Oxide, Bronchodilator Response and Inhaled Corticosteroid Type

2015 ◽  
Vol 22 (3) ◽  
pp. 153-156 ◽  
Author(s):  
Ryan W Smith ◽  
Kim Downey ◽  
Nadia Snow ◽  
Sharon Dell ◽  
W Gary Smith
Keyword(s):  
Nitrous Oxide ◽  
Inhaled Corticosteroids ◽  
Pediatric Asthma ◽  
Persistent Asthma ◽  
Forced Expiratory Volume ◽  
Parental Smoking ◽  
Type B ◽  
Bronchodilator Response ◽  
Percent Change ◽  
Forced Expiratory Flow

BACKGROUND: Fraction of exhaled nitrous oxide (FeNO) is a known marker of airway inflammation and a topic of recent investigation for asthma control in children.OBJECTIVE: To investigate the relationship among FeNO and bronchodilator response measured by spirometry and types of inhaled corticosteroids (ICS).METHODS: A one-year review of children tested with spirometry and FeNO in a regional pediatric asthma centre was conducted.RESULTS: A total of 183 children were included (mean [± SD] age 12.8±2.8 years). Fluticasone was used most commonly (n=66 [36.1%]), followed by ciclesonide (n=50 [27.3%]). Most children (n=73 [39.9%]) had moderate persistent asthma. Increased FeNO was associated with percent change in forced expiratory volume in 1 s (FEV1) after bronchodilator adjusted for allergic rhinitis, parental smoking and ICS type (B=0.08 [95% CI 0.04 to 0.12]; P<0.001). Similarly, FeNO was associated with percent change in forced expiratory flow at 25% to 75% of the pulmonary volume (FEF25–75) after bronchodilator adjusted for parental smoking and ICS type (B=0.13 [95% CI 0.01 to 0.24]; P=0.03). FeNO accounted for only 16% and 9% of the variability in FEV1and FEF25–75, respectively. Mean-adjusted FeNO was lowest in fluticasone users compared with no ICS (mean difference 18.6 parts per billion [ppb] [95% CI 1.0 to 36.2]) and there was no difference in adjusted FeNO level between ciclesonide and no ICS (5.9 ppb [95% CI −9.0 to 20.8]).CONCLUSION: FeNO levels correlated with bronchodilator response in a regional pediatric asthma centre. However, FeNO accounted for only 16% and 9% of the variability in FEV1and FEF25–75, respectively. Mean adjusted FeNO varied according to ICS type, suggesting a difference in relative efficacy between ICS beyond their dose equivalents.

scholarly journals Is there an association between the value of forced expiratory volume in the 1st second, the Asthma Control Test and a Control Framework by Global Initiative for asthma in asthmatic children and adolescents treated with inhaled corticosteroids?

2019 ◽  
Vol 29 (3) ◽  
pp. 346-353
Author(s):  
Karla Delevedove Taglia-Ferre ◽  
Sandra Lisboa ◽  
Luanda Dias da S. Salviano ◽  
Ana Carolina Carioca da Costa ◽  
Shandra Lisboa Monteiro ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Asthma Control ◽  
Control Method ◽  
Inhaled Corticosteroids ◽  
Forced Expiratory Volume ◽  
Control Test ◽  
Asthma Control Test ◽  
Asthmatic Children ◽  
Global Initiative For Asthma ◽  
Global Initiative

Objective: Evaluate the presence of association between the classification of the level of asthma control, using the method proposed by the Global Initiative for Asthma (GINA), the Asthma Control Test (ACT)/Childhood-ACT and the forced expiratory volume in the 1st second (FEV1), in asthmatic children and adolescents treated with inhaled corticosteroids, followed up at the National Institute of Women's, Children's and Adolescents' Health FernandesFigueira of the Oswaldo Cruz Foundation (IFF / FIOCRUZ). Method: A cross-sectional study was carried out with a review of the medical records of all children between 7 and 17 years of age followed up at the Asthma Outpatient Clinic and referred to the Respiratory Insertion Test (PFR) sector between March 2013 and September 2014. In the same day were applied the C-ACT/ACT questionnaires, an asthma control method proposed by the GINA and the FEV1 value in a spirometrictest. Results: From the total number of records evaluated (72), 16 children were excluded because they did not meet the required criteria for performing spirometry. The sample studied (56 children) was predominantly male (58.9%) and median age was 12 (7-17) years. It was observed an association between FEV1 and GINA values ??(p <0.01). Conclusion: The results found in this study indicate that FEV1 measurement is a useful component among the instruments for assessing clinical control of asthma by GINA.

Effectiveness of Montelukast versus Budesonide on Quality of Life and Bronchial Reactivity in Subjects with Mild-Persistent Asthma

2002 ◽  
Vol 15 (2) ◽  
pp. 149-155 ◽  
Author(s):  
G. Riccioni ◽  
E. Ballone ◽  
N. D'Orazio ◽  
S. Sensi ◽  
M. di Nicola ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inhaled Corticosteroids ◽  
Challenge Test ◽  
Persistent Asthma ◽  
Wilcoxon Test ◽  
Bronchial Reactivity ◽  
Treatment Groups ◽  
Mild Persistent Asthma ◽  
Group B

Insufficient data exist to evaluate the comparative effects of inhaled corticosteroids (ICS) versus leukotriene receptor antagonist (LTRA) on airway inflammation and quality of life (QoL). The aim of the study was to compare the effectiveness of montelukast compared to budesonide at different doses on QoL and bronchial reactivity in mild-asthmatic adult patients. 45 subjects with bronchial asthma were randomly assigned to a different treatment and divided in 3 treatment groups: A: 400 μg of budesonide twice a day; B: 10 mg of montelukast daily; C: 10 mg of montelukast daily plus 400 μg of budesonide twice a day. At the beginning of the study and at the end of the treatment period (16 weeks) all patients underwent complete clinical evaluation, pulmonary function testing and methacholine challenge test (MCHt). In group A the increase from baseline was 153.4%, in group C was 133.2%, and in group B 247.7%, the latter increase being statistically significant compared to that in the other 2 groups (p< 0.005 Wilcoxon test). In all domains the improvement in quality of life in the group treated with montelukast (group B) was significantly greater than that in the group treated with both medications (group C): in particular, the improvement was consistent in the symptoms (p< 0.01) and emotions (p< 0.01) domains, and weaker in the physical activity (p< 0.05). A similar difference was observed between group B and A, but only in the symptoms (p<0.01), emotions (p<0.01), and environmental stimuli domains (p<0.05). The personal perception of their own disease is important for a correct therapeutic management of asthma. In order to optimize the treatment, a complete adherence of the patient to the treatment itself is required, to be achieved through simplification of therapeutic schedule and easy administration of medications. Montelukast may be considered a valid alternative in the treatment of mild-persistent asthma, both for the clinical and functional benefits and for the great advantage of the once-daily dosage, which consistently improves the compliance with the chronic treatment of the disease.

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