Effects of budesonide and fluticasone propionate in pediatric asthma patients.
BACKGROUND
Cytokines and chemokines play important roles in asthma. However, little information exists on the effects of inhaled corticosteroids on cytokine and chemokine plasma levels in childhood asthma. We compared the pharmaceutical effects of two inhaled corticosteroids used in pediatric patients with mild-to-moderate asthma, budesonide and fluticasone propionate.


METHODS
Pediatric patients aged 5-18 years old were enrolled in this randomized, open-label, observer-blinded study and received 3 months of treatment with either inhaled budesonide (200 microg/puff) or fluticasone propionate (250 microg/puff), at two puffs per day. Peak expiratory flow (PEF), exhaled nitric oxide, Asthma Control Test (ACT), plasma Levels of tumor necrosis factor-alpha, thymus and activation-regulated chemokine, and interferon-inducible protein 10 were measured before treatment and monthly for 3 months after treatment.


RESULTS
There were six patients in the budesonide group, and eight in the fluticasone group. After 3 months, both groups showed improved PEF. In the first month, PEF improved more in the budesonide group than in the fluticasone group, though the difference was not significant. After treatment, ACT scores in both groups were well controlled, except for one patient in the fluticasone group. The fluticasone group had a more significant reduction in exhaled nitric oxide than the budesonide group in the first month.


CONCLUSIONS
Improvements in lung function were more rapid in the budesonide group than the fluticasone group. However, patients in the fluticasone group had better anti-inflammatory responses than those in the budesonide group. We conclude that each inhaled corticosteroids have its own clinical and laboratory effects.
Kuo
Lin-Yu
LY
Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Hung
Chih-Hsing
CH
Tseng
Hsing-I
HI
Wu
Jiunn-Ren
JR
Jong
Yuh-Jyh
YJ
Chu
Yu-Te
YT
D000293:Adolescent; D000730:Androstadienes / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D001944:Breath Tests; D019819:Budesonide / Q000627:therapeutic use*; D054414:Chemokine CCL17 / Q000097:blood; D054357:Chemokine CXCL10 / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D000730:Androstadienes; C106230:CCL17 protein, human; C114753:CXCL10 protein, human; D054414:Chemokine CCL17; D054357:Chemokine CXCL10; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D019819:Budesonide; D000068298:Fluticasone