title: Effects of early intervention with inhaled budesonide on lung function in newly diagnosed asthma.
abstract: OBJECTIVE
  Asthmatic patients lose lung function faster than normal subjects. The effectiveness of early intervention with inhaled corticosteroids on this decline in lung function is not established in recent-onset disease.
  
  
  METHODS
  The Inhaled Steroid Treatment as Regular Therapy in Early Asthma study was a randomized, double-blind study in 7,165 patients (5 to 66 years old), with persistent asthma for < 2 years to determine whether early intervention with low-dose inhaled budesonide prevents severe asthma-related events and the decline in lung function. Patients received budesonide (200 mug qd for children < 11 years old and 400 mug qd for others) or placebo for 3 years in addition to usual asthma medications.
  
  
  RESULTS
  Treatment with budesonide significantly improved prebronchodilator and postbronchodilator FEV(1) percentage of predicted and reduced the mean declines from baseline for postbronchodilator FEV(1) at 1 year and 3 years: - 0.62% and - 1.79% for budesonide and - 2.11% and - 2.68% for placebo, respectively (p < 0.001). The decline was more marked for male patients, active smokers, and patients > 18 years old, and the smallest treatment effects were in adolescents.
  
  
  CONCLUSIONS
  Long-term, once-daily treatment with low-dose budesonide improved both prebronchodilator and postbronchodilator FEV(1) in patients with recent-onset, persistent asthma, and reduced the loss of lung function over time.
authors.affiliation: Department of Medicine, McMaster University Medical Center, 1200 Main St West, Hamilton, ON, Canada. obyrnep@mcmaster.ca
authors.forename: Paul M
authors.initials: PM
authors.lastname: O'Byrne
authors.forename: Søren
authors.initials: S
authors.lastname: Pedersen
authors.forename: William W
authors.initials: WW
authors.lastname: Busse
authors.forename: Wan C
authors.initials: WC
authors.lastname: Tan
authors.forename: Yu-Zhi
authors.initials: YZ
authors.lastname: Chen
authors.forename: Stefan V
authors.initials: SV
authors.lastname: Ohlsson
authors.forename: Anders
authors.initials: A
authors.lastname: Ullman
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Lamm
authors.forename: Romain A
authors.initials: RA
authors.lastname: Pauwels
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D019819:Budesonide / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D001993:Bronchodilator Agents; D019819:Budesonide