title: Effect of inhaled budesonide on bronchial hyperresponsiveness in adolescents with clinical remission of asthma.
abstract: OBJECTIVE
  Many children with asthma go into long-term clinical remission at adolescence, but bronchial hyperresponsiveness (BHR) persists in some of these subjects. The regular use of inhaled corticosteroids improves BHR in patients with symptomatic asthma. The aim of this study was to determine whether BHR in adolescents with asthma remission could be reduced by prolonged treatment with inhaled corticosteroids.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled, parallel study.
  
  
  METHODS
  Thirty-seven adolescents with BHR and long-term remission of their asthma (neither symptoms nor any medication use during the previous 2 years).
  
  
  METHODS
  Subjects received inhaled budesonide (two 200-microg puffs bid; budesonide group, n = 19) or identical placebo (placebo group, n = 18) for 9 months. A separate group of patients with symptomatic asthma (symptomatic group, n = 19), using the same regimen of budesonide, was also studied.
  
  
  RESULTS
  The provocative concentration of methacholine producing a 20% fall in FEV(1) (PC(20)) was measured before and every 3 months during treatment. There was no significant difference among the three groups for the baseline PC(20). In neither the placebo nor the budesonide group did the geometric mean of PC(20) change significantly over the 9-month period. In contrast, a significant increase in PC(20) was noted in the symptomatic group as a result of the budesonide treatment.
  
  
  CONCLUSIONS
  Our data have shown that budesonide inhaled regularly for 9 months did not cause a significant improvement in the BHR of adolescents with long-term asthma remission. This suggests that the mechanism underlying BHR in this clinical setting may be different from that in symptomatic asthma.
authors.affiliation: Department of Pediatrics and Clinical Research Institute, Seoul National University Hospital, Seoul, Korea. kohyy@plaza.snu.ac.kr
authors.forename: Y Y
authors.initials: YY
authors.lastname: Koh
authors.forename: Y H
authors.initials: YH
authors.lastname: Sun
authors.forename: H S
authors.initials: HS
authors.lastname: Lim
authors.forename: C K
authors.initials: CK
authors.lastname: Kim
authors.forename: S J
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D001249:Asthma / Q000188:drug therapy*; D016535:Bronchial Hyperreactivity / Q000188:drug therapy*; D001985:Bronchial Provocation Tests; D019819:Budesonide / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male
chemical_list: D019819:Budesonide