Chest
Original ResearchEffects of Early Intervention With Inhaled Budesonide on Lung Function in Newly Diagnosed Asthma
Section snippets
Materials and Methods
The study design, methods, and inclusion and exclusion criteria of the START trial are described in detail elsewhere.10 The study enrolled 7,241 patients aged 5 to 66 years from 32 countries. Patients had asthma symptoms weekly, but not daily, during the 3 months prior to study. These symptoms had to be present for < 2 years (ideally < 1 year). Patients demonstrated airway obstruction by an increase in FEV1 > 12% after a β2-agonist, a fall in FEV1 > 15% after exercise, or a variation > 15% in
Results
Of the 7,241 patients that entered the study, 7,165 were available for analysis, of whom 3,597 were randomized to budesonide and 3,568 to placebo. From this cohort, 2,010 patients did not complete the 3 years of double-blind treatment. The dropout rate (27.5% in the budesonide group and 28.6% in the placebo group) and the mean time in the study (2.47 years in the budesonide group and 2.44 years in the placebo group) were comparable for the two treatment arms. There were 3,419 patients in the
Discussion
This study is the first large, prospective evaluation of the effects of early intervention with inhaled corticosteroids on asthma progression, as determined by the development of severe asthma-related events and changes in lung function. In this study, average duration of time since asthma diagnosis was < 1 year. The study demonstrated that treatment with low doses of inhaled budesonide improved both prebronchodilator and postbronchodilator FEV1, and this effect persisted over the 3 years of
Safety Committee
A. Sheffer (Boston, MA [Chairman]); A. Woolcock (Sydney, Australia); P. Diaz (Santiago, Chile); M. Silverman (Leicester, UK); B. Lindmark (Lund, Sweden [nonvoting member]).
Western and Central Europe
Austria (n = 88 patients recruited): Josef Eckmayr, Josef Riedler, Gert Wurzinger, Günter Ott, Jasminka Zarkovic, Andrea Schulheim, Manfred Götz, Herwig Schinko, Ingrid Thomüller; Belgium (n = 223): Wilfried de Backer, Hugo van Bever, Geert Verleden, Christiane de Boeck, Joseph Aumann, Walter Vincken, Isidor Dab, Paul de
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Cited by (95)
Novel Immunomodulatory Therapies for Respiratory Pathologies
2022, Comprehensive PharmacologyThe impact of budesonide inhalation suspension for asthma hospitalization: In terms of length of stay, recovery time from symptoms, and hospitalization costs
2020, Allergology InternationalCitation Excerpt :Inhaled corticosteroids (ICSs) has a crucial role in the treatment of asthma in clinical practice. Budesonide, one of ICSs, reduces the risk of asthma exacerbation and improves asthma control and lung function in mild adult asthmatics7,8 even if patients have been smoking.9 Several delivery devices are available for the inhalation of budesonide; dry powder and metered dose inhalers, and a nebulizer.10,11
Clinical Approach to the Therapy of Asthma-COPD Overlap
2019, ChestCitation Excerpt :In asthma, ICSs are introduced early in the treatment for patients who are symptomatic. ICSs decrease the risk of severe exacerbations, improve asthma control, and reduce the loss of lung function over time in patients with mild asthma.24,25 Moreover, patients with asthma who stop ICSs have a higher risk of future exacerbations than those who continue therapy.26
Can inhaled corticosteroids modify the natural history of asthma in children?
2016, Revue Francaise d'Allergologie
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml)
This study was funded by AstraZeneca R&D, Lund, Sweden.
†Dr. Pauwels died in January 2005.