[Effect of two doses of budesonide on exhaled nitric oxide and urinary EPX excretion in asthmatic children].
The use of objective outcome measures that assess airway inflammation in pediatric asthma can provide a good evaluation of asthma severity and treatment response. In this double-blind and randomized study the effects of 200 micro g of budesonide and 800 micro g of budesonide on markers of inflammation (exhaled nitric oxide (eNO), eosinophil protein X (EPX) excretion in urine) and on lung function (FEV (1)) were prospectively investigated in 24 ICS-naive children with mild persistent to moderate persistent asthma over a period of eight weeks. After eight weeks of treatment 200 micro g and 800 micro g of budesonide led to a significant decrease (p < 0.025) in eNO [median (90 % interval): 200 micro g: - 17.2 ppb (- 54.6 to 0.9); 800 micro g: - 13.2 ppb (- 44.6 to - 1.7)]. A significant change in urinary EPX excretion was only observed in the high dose group [200 micro g: - 10.3 micro g/mmol creatinine (- 116.2 to 50.5), p = 0.9; 800 micro g: - 49.2 micro g/mmol creatinine (- 231.0 to 48.7), p = 0.02]. However, a significant difference between the change from baseline after 8 weeks of either group was found neither for eNO (p = 0.66) nor for EPX excretion (p = 0.04). In conclusion, our data demonstrate that 800 micro g budesonide per day did not show any advantage in reduction of airway inflammation, measured by eNO and urinary EPX excretion, in children with mild persistent to moderate persistent asthma.
Storm Van's Gravesande
K
K
Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Freiburg. karin.storm@gmx.de
Mattes
J
J
Endlicher
A
A
Alving
K
K
Ihorst
G
G
Kühr
J
J
D000293:Adolescent; D001249:Asthma / Q000503:physiopathology* / Q000652:urine; D001944:Breath Tests; D001993:Bronchodilator Agents / Q000494:pharmacology*; D019819:Budesonide / Q000494:pharmacology*; D002648:Child; D004305:Dose-Response Relationship, Drug; D047208:Eosinophil-Derived Neurotoxin; D005260:Female; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000032:analysis*; D012129:Respiratory Function Tests; D012260:Ribonucleases / Q000652:urine*
D001993:Bronchodilator Agents; D009569:Nitric Oxide; D019819:Budesonide; D047208:Eosinophil-Derived Neurotoxin; D012260:Ribonucleases