INHALATION TREATMENT WITH BUDENOSIDE IN ASTHMA - A COMPARISON OF TURBUHALER(R) AND METERED-DOSE INHALATION WITH NEBUHALER(R)

We assessed the preference, efficacy and tolerability of budesonide tr eatment with Turbuhaler(R) in 24 previously steroid-free asthmatic pat ients by comparing it to the delivery of budesonide by metered dose in haler (MDI) with Nebuhaler(R). In an open randomized, cross-over study we tested the two delivery techniques over two four-week periods with a dose of 400 mu g budesonide administered twice daily. Compared to t he findings in a two-week run-in period, lung function improved signif icantly with both active treatments, and there were no differences bet ween the two delivery techniques; FEV(1) increased compared to baselin e by 0.35 L with Turbuhaler (p<0.001) and 0.36 L (p<0.001) with Nebuha ler. Bronchial responsiveness to inhaled methacholine decreased signif icantly and equally with both budesonide treatments (Turbuhaler p<0.00 01; Nebuhaler p<0.002). Budesonide Turbuhaler and Nebuhaler were also equally efficient in increasing morning and evening peak expiratory fl ow rate (PEFR) as well as in attenuating the symptoms of asthma. The o verall incidence of oropharyngeal side effects was low with no signifi cant differences between the two delivery systems: irritation in the m outh or airways occurred in three patients with Turbuhaler and five wi th Nebuhaler, coughing after inhalation one with Turbuhaler and three with Nebuhaler; three reported hoarseness with Turbuhaler and one with Nebuhaler. The differences between the delivery systems were not sign ificant. Sixteen patients preferred Turbuhaler and eight Nebuhaler. Th ese data indicate that the Turbuhaler technique is an efficient and sa fe alternative when inhaled steroid treatment is considered for an ast hmatic patient.