NEBULIZED BUDESONIDE FOR THE TREATMENT OF MODERATE TO SEVERE ASTHMA IN INFANTS AND TODDLERS

Maintenance treatment with nebulized budesonide was studied in young c hildren with asthma not controlled without steroids. In a blind parall el-group study for 18 weeks, 102 children, mean age 22 (5-47) months, were randomized for treatment starting with 0.25 or 1 mg b.i.d. The pa tients were reviewed every 3 weeks, and if symptom control had been ac hieved the dose was reduced, otherwise it was kept. The clinical effec t was very good with both dose regimens. The median time to 7 consecut ive days without any asthma symptoms was about 1 month with both, high lighting the importance of the duration of therapy rather than the ben efits of a high starting dose. In 18 of 24 children who attained the p lacebo stage, symptoms had reappeared at the last visit. Although an o verall minimal effective maintenance dose could not be demonstrated, 4 7% achieved symptom control on 0.25 mg b.i.d., i.e. fulfilled criteria for further dose reduction. No significant side effects were seen. On average, 25% of the nominal dose reached the patients.