title: Budesonide inhalation suspension versus methylprednisolone for treatment of moderate bronchial asthma attacks.
abstract: BACKGROUND
  Owing to their side effects, administration of steroids for bronchial asthma attacks should be minimized. We investigated whether budesonide inhalation suspension (BIS) could replace intravenous steroid administration for the treatment of moderate bronchial asthma attacks.
  
  
  METHODS
  The subjects were children aged 5 years and younger hospitalized for moderate bronchial asthma attacks. Patients were randomly assigned to one of two groups: 20 patients received methylprednisolone (mPSL) and 20 were treated with BIS. The mPSL group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and disodium cromoglycate (2 mL) three times a day and systemic administration of mPSL (1 mg/kg) three times a day. The BIS group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and BIS (0.5 mg) three times a day. The frequency of inhalations and steroid administration was adjusted according to the severity of symptoms. The cortisol level at discharge was measured.
  
  
  RESULTS
  There were no significant differences between the two groups in terms of the severity of attacks and duration of management, or in terms of therapeutic efficacy, duration of wheezing, or period of hospitalization. The frequency of inhalations on days 3 to 6 of hospitalization was lower in the BIS group than in the mPSL group, and the cortisol level at discharge was significantly higher in the BIS group (13.9 ± 6.1 μg/dL) than in the mPSL group (8.0 ± 2.1 μg/dL) (p = 0.008).
  
  
  CONCLUSIONS
  In patients with recurrent wheezing or bronchial asthma of <5 years, the efficacy of BIS is equivalent or better than mPSL for moderate bronchial asthma attacks, and in contrast to steroid treatment, BIS treatment do not suppress adrenocortical function.
authors.affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Yanagida
authors.affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Morimitsu
authors.initials: M
authors.lastname: Tomikawa
authors.affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Shukuya
authors.affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Iguchi
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Ebisawa
keywords: Asthma; Budesonide; Cortisol; Inhalation; Methylprednisolone; Procaterol