Effect of inhaled budesonide therapy on lung function in schoolchildren born preterm

We investigated the effect of inhaled glucocorticoid (GC) on bronchial obst ruction and on bronchial lability in schoolchildren born preterm. Twenty-one children with bronchial obstruction, increased responsiveness to a beta (2)-agonist, and/or increased diurnal variation in peak expiratory flow (PEF) were selected for an open longitudinal study of the value of inh aled GC. None of these children had an earlier diagnosis of asthma or curre nt GC treatment. Eighteen children with median (range) birth weight 1025 (6 40-1600)g and gestational age 28 (26-35) weeks, age at study 10.1 (7.7-13) years, were treated with inhaled budesonide in initially high (0.8 mgm(-2)d ay(-1) for 1 month) and subsequently lower dose (0.4mgm(-2)day(-1) for 3 mo nths). Daily symptom scores were recorded. Spirometric values were measured in the clinic at the beginning and end of each treatment period. At home, children used a data storage spirometer. After treatment with budesonide for 4 months, spirometric values in the cli nic did not significantly change. The median forced expiratory volume in 1 sec (FEV1) was 74% of predicted both at entry and after budesonide treatmen t. However, the median number of greater than or equal to 20% diurnal chang e in PEF values at home decreased during treatment. According to the present study, inhaled budesonide for 4 months had no sign ificant effect on basic lung function but may decrease bronchial lability i n schoolchildren born preterm.