Comparison of the Effect of Clinical Practice Guide of Budesonide (Pulmicort) and Standard Method in the Management of Asthma Attack

Document Type : Original Article (s)

Authors

1 Resident, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Asthma is the most common chronic respiratory tract disorder, and so far, numerous methods for controlling asthma attacks have been presented. The aim of this study was to compare the effect of the use of the budesonide (Pulmicort) clinical guide with the current standard treatment of acute asthma attacks.Methods: In this randomized clinical trial study, 90 patients with history or presentation of acute asthma attack were selected, and randomly divided into two groups of 45. The intervention group received 0.5 mg inhaled budesonide for one time plus standard protocol, and the control group received standard protocol only. The standard protocol consisted of 5 mg of salbutamol (4-10 puff) in 3 doses (with an interval of 20 minutes) via nebulizer, 0.5 mg of ipratropium in 3 doses (with an interval of 20 minutes) via inhalation, and 50 mg of prednisolone orally. Then, the peak expiratory flow rate (PEFR), forced expiratory volume in one second (FEV1), and hemodynamic parameters at 20th, 40th, and 60th minutes were measured and compared between the two groups.Findings: In intervention and control groups, the mean PEFR was 180.04 ± 8.51 and 175.17 ± 6.25 liter/minute (P = 0.003), 225.88 ± 13.34 and 219.68 ± 13.21 liter/minute (P = 0.029), and 424.02 ± 86.8 and 361.64 ± 75.44 liter/minute (P < 0.001) at 20th, 40th, and 60th minutes, respectively.Conclusion: It seems that budesonide (Pulmicort) protocol appears to be effective in accelerating the treatment process in acute asthma attacks.

Keywords

References

  1. American Lung Association. Epidemiology and Statistics Unit, Research and Program Services. 2012.
  2. National Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Clinical Practice Guidelines. Bethesda, MD: National Heart, Lung, and Blood Institute (US); 2007.
  3. Ivanova JI, Bergman R, Birnbaum HG, Colice GL, Silverman RA, McLaurin K. Effect of asthma exacerbations on health care costs among asthmatic patients with moderate and severe persistent asthma. J Allergy Clin Immunol 2012; 129(5): 1229-35.
  4. National Institutes of Health, National Heart, Lung and Blood Institute. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention: NHLBI/WHO Workshop Report. Bethesda, MD: NIH; 2012.
  5. National Institutes of Health and National Heart, Lung, and Blood Institute. Guidelines for the diagnosis and management of asthma–update on selected topics 2002. Washington, DC: US Dept of Health and Human Services; 2002.
  6. National Asthma Council. Asthma Management Handbook 2002. Melboune, Australia: National Asthma Council Australia; 2002.
  7. British Thoracic Society; Scottish Intercollegiate Guidelines Network.British guideline on the management of asthma. Thorax 2003; 58(Suppl 1): i1-94.
  8. Becker A, Lemiere C, Berube D, Boulet LP, Ducharme FM, FitzGerald M, et al. Summary of recommendations from the Canadian Asthma Consensus guidelines, 2003. CMAJ 2005; 173(6 Suppl): S3-11.
  9. Fischl MA, Pitchenik A, Gardner LB. An index predicting relapse and need for hospitalization in patients with acute bronchial asthma. N Engl J Med 1981; 305(14): 783-9.
  10. Hall IP. Pharmacogenetics of asthma. Eur Respir J 2000; 15(3): 449-51.
  11. Drazen JM, Silverman EK, Lee TH. Heterogeneity of therapeutic responses in asthma. Br Med Bull 2000; 56(4): 1054-70.
  12. Palmer LJ, Silverman ES, Weiss ST, Drazen JM. Pharmacogenetics of asthma. Am J Respir Crit Care Med 2002; 165(7): 861-6.
  13. Koga T, Kamimura T, Oshita Y, Narita Y, Mukaino T, Nishimura M, et al. Determinants of bronchodilator responsiveness in patients with controlled asthma. J Asthma 2006; 43(1): 71-4.
  14. Tsai HJ, Shaikh N, Kho JY, Battle N, Naqvi M, Navarro D, et al. Beta 2-adrenergic receptor polymorphisms: pharmacogenetic response to bronchodilator among African American asthmatics. Hum Genet 2006; 119(5): 547-57.
  15. Kercsmar CM, McDowell KM. Love it or lev it: levalbuterol for severe acute asthma--for now, leave it. J Pediatr 2009; 155(2): 162-4.
  16. Tantisira KG, Hwang ES, Raby BA, Silverman ES, Lake SL, Richter BG, et al. TBX21: a functional variant predicts improvement in asthma with the use of inhaled corticosteroids. Proc Natl Acad Sci USA 2004; 101(52): 18099-104.
  17. Tantisira KG, Lake S, Silverman ES, Palmer LJ, Lazarus R, Silverman EK, et al. Corticosteroid pharmacogenetics: association of sequence variants in CRHR1 with improved lung function in asthmatics treated with inhaled corticosteroids. Hum Mol Genet 2004; 13(13): 1353-9.
  18. Tantisira KG, Silverman ES, Mariani TJ, Xu J, Richter BG, Klanderman BJ, et al. FCER2: a pharmacogenetic basis for severe exacerbations in children with asthma. J Allergy Clin Immunol 2007; 120(6): 1285-91.
  19. Walls R, Hockberger R, Gausche-Hill M. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2017.
  20. Global Initiative for Asthma (GINA). 2016 GINA report: Global strategy for asthma management and prevention [Online]. [cited 2016]; Available from: URL: https://ginasthma.org/wp-content/uploads/2016/04/GINA-2016-main-report_tracked.pdf
  21. Price DB, Gefen E, Gopalan G, Miglio C, McDonald R, Thomas V, et al. Real-life effectiveness and safety of the inhalation suspension budesonide comparator vs the originator product for the treatment of patients with asthma: a historical cohort study using a US health claims database. Pragmat Obs Res 2017; 8: 69-83.
  22. Leflein JG, Gawchik SM, Galant SP, Lyzell E, Young M, Cruz-Rivera M, et al. Safety of budesonide inhalation suspension (Pulmicort Respules) after up to 52 weeks of treatment in infants and young children with persistent asthma. Allergy Asthma Proc 2001; 22(6): 359-66.
  23. Szefler SJ, Lyzell E, Fitzpatrick S, Cruz-Rivera M. Safety profile of budesonide inhalation suspension in the pediatric population: worldwide experience. Ann Allergy Asthma Immunol 2004; 93(1): 83-90.
  24. Thomas V, Price D, Yau S, Mcdonald R, Chong C, Gefen E. Real-life effectiveness and safety of comparator budesonide inhalation suspension is noninferior to originator product for asthma patients. Respirology 2015; 20(Suppl S3): 20.
  25. Yanagida N, Tomikawa M, Shukuya A, Iguchi M, Ebisawa M. Budesonide inhalation suspension versus methylprednisolone for treatment of moderate bronchial asthma attacks. World Allergy Organ J 2015; 8(1): 14.
  26. Emami M, Tayebi A, Gharipour M, Farzamnia S, Temyarti AK. Comparing clinical efficacy of Symbicort versus Pulmicort in reducing asthma symptom and improving its control. Adv Biomed Res 2014; 3: 86.
  27. Chi CH, Liao JP, Zhao YN, Li XY, Wang GF. Effect of Inhaled Budesonide on Interleukin-4 and Interleukin-6 in Exhaled Breath Condensate of Asthmatic Patients. Chin Med J (Engl) 2016; 129(7): 819-23.
Journal of Isfahan Medical School
Volume 37, Issue 530 - Serial Number 530
March and April 2019
Pages 630-636

Files

History

  • Receive Date: 12 June 2019
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics