INHALED BUDESONIDE IN THE TREATMENT OF ASTHMA: LESSONS OF PHARMACOLOCIGAL STUDIES

Abstract

Inhaled corticosteroids (ICS) are the preferred medications for long-term asthma therapy. The new studies with ICS budesonide provide interesting information, which supplement current asthma guidelines. The data of 3-year double-blind START (inhaled Steroid Treatment As Regular Therapy) study showed, that early treatment with inhaled budesonide improves airway impairment and reduces the future risk of severe exacerbations in adults and children with newly diagnosed and previously untreated bronchial asthma. Unfortunately, the impact of early ICS treatment on long-term changes in lung function has not been proven. CAMP study (Childhood Asthma Management Program) also confirmed that ICS treatment does not affect the progression of asthma. Nevertheless, the contribution of the CAMP study into asthma treatment guidelines is important, because it confirms the need for continuous treatment with ICS in order to improve asthma control even with no influence on natural course of the disease. Asthmatic patients often avoid taking ICS for a long time. The most common reason - the worry of side effects. That’s why researches are looking for ways to minimize side effects and make treatment more comfortable. The START study confirmed the efficacy and safety of using budesonide once daily. The OPTIMA (Oxis and Pulmicort Turbuhaler in the Management of Asthma) and FACET (Formoterol Corticosteroids and Establishing Therapy) study showed the efficacy and safety of combined therapy for moderate to severe asthma treatment. Taken together, these studies have supported the daily ICS treatment for mild to moderate asthma, recommend the early ICS treatment and introduce the indications of combined therapy.