Dose-response comparison of systemic bioactivity with inhaled budesonide and triamcinolone acetonide in asthmatic adults
Background: Budesonide (BUD) has recently been licensed for treatment of asthma in the United States, whereas triamcinolone acetonide (TAA) has been used for many years. Objective: We sought to evaluate the dose-response effect of inhaled BUD and TAA in terms of adrenal, bone, and blood markers. Met...
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Veröffentlicht in: | Journal of allergy and clinical immunology 1998-11, Vol.102 (5), p.751-756 |
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Zusammenfassung: | Background: Budesonide (BUD) has recently been licensed for treatment of asthma in the United States, whereas triamcinolone acetonide (TAA) has been used for many years.
Objective: We sought to evaluate the dose-response effect of inhaled BUD and TAA in terms of adrenal, bone, and blood markers.
Methods: Twelve asthmatic subjects (mean age, 32 years; mean FEV
1 , 91% of predicted value) were studied in a randomized design comparing 3 days of treatment with placebo and low (200 μg twice daily), medium (400 μg twice daily), and high (800 μg twice daily) doses of BUD (Pulmicort Turbuhaler, 100 μg) and TAA (Azmacort integrated actuator/spacer, 100 μg) with a 7-day period at crossover, when patients received their usual inhaled corticosteroid therapy. Measurements were made at 8 am for serum cortisol, osteocalcin, and blood eosinophils. Measurements were also made for overnight urinary cortisol/creatinine excretion.
Results: For all measurements there were no significant differences between the 2 treatments at any dose level. Ratios between BUD and TAA (95% CI) at the highest dose levels were as follows: 8 am serum cortisol, 1.08-fold (0.63 to 1.85); urinary cortisol, 1.09-fold (0.63 to 1.86); eosinophils, 0.98-fold (0.69 to 1.38); and osteocalcin 1.05-fold (0.78 to 1.41). There was no evidence of a significant overall dose-response effect for any parameter of hypothalamo-pituitary-adrenocortical axis activity, with neither drug being significantly different from placebo at any dose. For the 3 dose levels of both drugs, total abnormal low values for 8 am serum cortisol (ie, |
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ISSN: | 0091-6749 1097-6825 |
DOI: | 10.1016/S0091-6749(98)70014-4 |