Objective:To analyze the clinical efficacy of tiotropium bromide(TB)combined with budesonide formoterol(BUD/FM)inhalation in treating chronic obstructive pulmonary disease(COPD).Methods:62 COPD patients admitted to th...Objective:To analyze the clinical efficacy of tiotropium bromide(TB)combined with budesonide formoterol(BUD/FM)inhalation in treating chronic obstructive pulmonary disease(COPD).Methods:62 COPD patients admitted to the hospital between June 2020 and December 2022 were selected as samples for this study.The patients were divided into a combination group and a conventional group using the random number table method,with 31 cases in each group.The patients in the combination group were treated with TB combined with BUD/FM inhalation,whereas the patients in the conventional group were treated with BUD/FM inhalation only.The treatment efficacy and changes in lung function indicators of both groups were compared.Results:The total efficacy of treatment in the combined group was higher than that in the conventional group,and the difference was statistically significant(P<0.05).Before treatment,there was no difference in pulmonary function indicators between the two groups(P>0.05).After three months of treatment,all lung function indicators of the combined group were higher than those of the conventional group,and the difference was statistically significant(P<0.05).Conclusion:Combining TB with BUD/FM inhalation therapy increases the efficacy of treatment for patients with COPD.Besides,it also improves lung function and leads to a better prognosis.展开更多
Objective:To analyze the effect of combined inhalation of budesonide formoterol and tiotropium bromide on arterial blood gas and pulmonary function indexes in patients with chronic obstructive pulmonary disease(COPD)....Objective:To analyze the effect of combined inhalation of budesonide formoterol and tiotropium bromide on arterial blood gas and pulmonary function indexes in patients with chronic obstructive pulmonary disease(COPD).Methods:100 patients with COPD treated from January to December 2022 were selected as observation objects,and were divided into a control group(n=50,in which budesonide and formoterol were administered)and an experimental group(n=50,the treatment drug was budesonide formoterol combined with tiotropium bromide)according to the computer grouping method,and compared the treatment results.Results:(i)Before treatment,there was no difference in the partial pressure of carbon dioxide and partial pressure of oxygen between the control group and the experimental group(P>0.05);after treatment,the partial pressure of carbon dioxide and partial pressure of oxygen in the experimental group were higher than those in the control group,with significant differences(P<0.05).(ii)Before treatment,there was no difference in forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC between the control group and the experimental group(P>0.05);after treatment,the FVC,FEV1,and FEV1/FVC in the experimental group were significantly higher than those in the control group(P<0.05).(iii)There was no difference in the levels of CRP,IL-6,and TNF-αbetween the control group and the experimental group(P>0.05);after treatment,the levels of CRP,IL-6,and TNF-αin the experimental group were lower than those in the control group,with significant differences(P<0.05).(iv)Compared to the total incidence of adverse reactions in the control group(28.00%),the incidence of total adverse reactions in the experimental group was lower at 10.00%,and the difference was significant(P<0.05).Conclusion:The combined inhalation of budesonide and formoterol with tiotropium bromide has demonstrated a clear therapeutic efficacy and safety in treating chronic obstructive pulmonary disease.This treatment approach effectively enhances arterial blood gas levels and lung function,showing promising potential for widespread application.展开更多
Objective:To explore and analyze the effect of nebulized budesonide inhalation on children with asthma and its influence on immune indexes.Methods:300 children who were with asthma admitted to the Pediatric Respirator...Objective:To explore and analyze the effect of nebulized budesonide inhalation on children with asthma and its influence on immune indexes.Methods:300 children who were with asthma admitted to the Pediatric Respiratory Department of our hospital from January 2021 to January 2023 were selected as the research subjects.The patients were divided into a nebulization group(n=150)and a reference group(n=150)by drawing lots.The nebulization group received routine treatment along with budesonide nebulization inhalation therapy,while the reference group only received routine treatment.The treatment effect,the immune indicators,the time taken for the disappearance of symptoms,and the pulmonary function indicators of both groups were compared.Results:The total efficacy of treatment received in the nebulization group was significantly higher than that in the reference group(P<0.05).Before treatment,there was no statistically significant difference in the CD4^(+),CD8^(+),CD4^(+)/CD8^(+),between the two groups(P>0.05);after treatment,the nebulization group’s CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and other immune indicators were significantly better than the reference group(P<0.05).The time taken for the disappearance of symptoms like wheezing,coughing,crackles,shortness of breath,and other symptoms in the nebulization group was significantly shorter than in the reference group(P<0.05).Before treatment,there was no statistically significant difference in the pulmonary function indexes such as FEV1,PEF,and FVC between the two groups(P>0.05);after treatment,the pulmonary function indexes of the patients in the nebulization group were significantly better than those in the reference group(P<0.05).Conclusion:Nebulized budesonide inhalation therapy has shown significant efficacy in the treatment of pediatric asthma,with notable improvements in immune indicators.Therefore,it is worthy of recommendation and further promotion.展开更多
Budesonide is a corticosteroid used for the treatment of asthma via various matrices and inhalation mechanisms. An unknown peak of Budesonide aqueous formulation has been investigated during stability study wherein th...Budesonide is a corticosteroid used for the treatment of asthma via various matrices and inhalation mechanisms. An unknown peak of Budesonide aqueous formulation has been investigated during stability study wherein the impurity level observed around 0.1% well below the threshold 0.5%. The approach to identify anonymous species was adopted as first to generate the impurity in sample, isolate, enrich and was subjected to LC-MS/MS and NMR for spectral studies. Based on the spectral data the anonymous species were identified as a “Lumibudesonide’’ ((5aR,5bS,5cS,6S,7aS,7bS,10aR,11aS,11bS)-6-hydroxy-7b-(2-hydroxyacetyl)-5b,7a-dimethyl-9-propyl 1,5a,5b,5c,6,7,7a,7b,10a,11,11a,11b dodecahydrocyclopenta[2'',3'']cyclopropa [1'',2'':3', 4']benzo [1',2':4,5]indeno [1,2-d][1,3]dioxol-5(2H)-one), which is observed in photolysis of Budesonide.展开更多
Eosinophilic cholangitis is a rare cause of deranged obstructive liver function tests. It has been described as a great mimicker for malignant biliary strictures and bile duct obstruction. There are only case reports ...Eosinophilic cholangitis is a rare cause of deranged obstructive liver function tests. It has been described as a great mimicker for malignant biliary strictures and bile duct obstruction. There are only case reports available on treatment experience for eosinophilic cholangitis. A large proportion of patients present with biliary strictures for which they have undergone surgery or endoscopic treatment and a small proportion was given systemic corticosteroid. We share our treatment experience using budesonide which has fewer systemic side effects to prednisolone and avoids invasive management.展开更多
Purpose: Since intravesically administered steroid therapy may treat bladder pain syndrome/interstitial cystitis (BPS/IC) with fewer side effects than the current treatment of orally administered steroids, we investig...Purpose: Since intravesically administered steroid therapy may treat bladder pain syndrome/interstitial cystitis (BPS/IC) with fewer side effects than the current treatment of orally administered steroids, we investigated whether the intravesical infusion of budesonide foam can effectively treat BPS/IC symptoms in a rat model of tranilast-induced BPS/IC. Methods: There were 6 rat treatment groups (n = 8 per group): control + single or daily saline infusion, tranilast + single or daily saline infusion, and tranilast + single or daily budesonide infusion. All groups except for the controls were fed a tranilast supplemented diet for 5 weeks. Budesonide and saline were infused intravesically. After the BPS/IC rat model underwent single infusion treatments, we measured the paw pain threshold using the von Frey test and continuous cystometry was taken. After two weeks of daily intravesical infusions, we measured locomotor activity and serum cortisol levels;harvested bladders underwent histological analysis. Results: Both pain threshold and locomotor activity were significantly lower in the saline-infused groups receiving the tranilast diet, but there were no differences between the budesonide-infused groups and the controls. The interval between bladder contractions was significantly shorter in the tranilast group than the control or tranilast + budesonide infusion groups. The serum cortisol levels did not change. Hematoxylin-Eosin stainings of the bladder showed thickening of the bladder muscle layer and mucosal edema in the tranilast group, while the tranilast + budesonide infusion group showed only mild changes. Conclusion: Intravesical infusion of budesonide effectively treated BPS/IC symptoms in a rat model of BPS/IC.展开更多
Objective:To study the influence of budesonide and salbutamol atomization inhalation on Th17/Treg balance in patients with bronchial asthma and its correlation with airway remodeling.Methods:A total of 90 patients wit...Objective:To study the influence of budesonide and salbutamol atomization inhalation on Th17/Treg balance in patients with bronchial asthma and its correlation with airway remodeling.Methods:A total of 90 patients with bronchial asthma who received systemic treatment in our hospital between July 2013 and April 2016 were divided into control group (n=45) and observation group (n=45) according to random number table. Patients in the control group were treated with salbutamol atomization inhalation alone while those in observation group were treated with budesonide and salbutamol atomization inhalation. The Th17/Treg ratio in peripheral blood as well as serum contents of airway remodeling-related indicators was compared between two groups before and after treatment. The correlation between Th17/Treg balance and airway remodeling in patients with bronchial asthma was detected by Pearson test. Results:Before treatment, the differences in peripheral blood Th17/Treg ratio as well as serum contents of inflammatory mediators, growth factor indexes and collagen metabolism indexes were not statistically significant between two groups of patients. After treatment, peripheral blood Th17/Treg ratio in observation group was lower than that in control group, serum CRP, IL-8, IL-13 and TNF- contents in observation group were lower than those in control group, serum PDGF-BB, b-FGF and VEGF contents in observation group were lower than those in control group, and serum HA, PCⅢ and LN contents in observation group were lower than those in control group. The Th17/Treg ratio in patients with bronchial asthma after treatment was positively correlated with the levels of airway remodeling-related indexes.Conclusion:Budesonide combined with salbutamol atomization inhalation can optimize the Th17/Treg balance in patients with bronchial asthma, and Th17/Treg is directly correlated to the degree of airway remodeling.展开更多
Objective: To investigate the effects of montelukast sodium combined with budesonide on pulmonary function, inflammatory factors and immunoglobulin in children with asthma. Methods: A total of 100 children with asthma...Objective: To investigate the effects of montelukast sodium combined with budesonide on pulmonary function, inflammatory factors and immunoglobulin in children with asthma. Methods: A total of 100 children with asthma treated in our hospital from May 2013 to November 2016 were randomly divided into control group and observation group. In the control group, budesonide inhalation therapy was given. On the basis of the control group, montelukast sodium treatment was given, pulmonary function, inflammatory factors and immunoglobulin levels in the two groups before and after treatment were measured. Results:Compared with before treatment, the levels of FEV1%, FEF50%, FEF25% and PEF% in the two groups were significantly increased, those in the observation group were higher than in control group;compared with before treatment, IL-10 levels were significantly increased, TNF-α and IL-8 levels were significantly decreased in the two groups after treatment, moreover those in the observation group IL-10 levels were significantly higher than the control group, TNF-α and IL-8 were significantly lower than those in the control group, the difference was statistically significant;Compared with before treatment, IgA and IgM levels were significantly increased in both groups after treatment, IgE levels were significantly decreased, and IgA and IgM levels in the observation group were significantly higher than in the control group, IgE levels were significantly lower than the control group, the difference was statistically. Conclusion: Montelukast sodium combined with budesonide can effectively reduce the inflammation level of children with asthma, improve lung function, enhance immunity, the effect is significant, it is worth further clinical application.展开更多
Objective: To study the effects of oral cetirizine combined with budesonide inhalation on immune inflammatory response in children with acute asthma attack. Methods: Children with acute asthma attack who were treated ...Objective: To study the effects of oral cetirizine combined with budesonide inhalation on immune inflammatory response in children with acute asthma attack. Methods: Children with acute asthma attack who were treated in Beijing Luhe Hospital Affiliated to Capital Medical University between April 2014 and February 2017 were selected and randomly divided into two groups, observation group received oral cetirizine combined with budesonide inhalation therapy, and control group received budesonide inhalation therapy. The contents of CD4+T cell subsets and the expression of immune transcription factors in peripheral blood as well as the contents of CD4+T cytokines and inflammatory mediators in serum were measured after 1 week of treatment. Results: After 1 week of treatment, Th1 and Treg contents as well as BCL11B, STAT4 and SOCS3 mRNA expression in peripheral blood as well as IFN-γand IL-10 contents in serum of observation group were greatly higher than those of control group while Th2, Th17 and Th22 contents as well as STAT1 and STAT3 mRNA expression in peripheral blood as well as IL-4, IL-17, IL-22, HMGB1, Periostin, Eotaxin and ADAM33 contents in serum were greatly lower than those of control group. Conclusion: Oral cetirizine combined with budesonide inhalation is more effective than budesonide inhalation alone to modulate the immune inflammatory response in children with acute asthma attack.展开更多
This study aims to understand the absorption patterns of three different kinds of inhaled formulations via in silico modeling using budesonide(BUD)as a model drug.The formulations investigated in this study are:(i)com...This study aims to understand the absorption patterns of three different kinds of inhaled formulations via in silico modeling using budesonide(BUD)as a model drug.The formulations investigated in this study are:(i)commercially available micronized BUD mixed with lactose(BUD-PT),(ii)BUD nanocrystal suspension(BUD-NC),(iii)BUD nanocrystals embedded hyaluronic acid microparticles(BUD-NEM).The deposition patterns of the three inhaled formulations in the rats’lungs were determined in vivo and in silico predicted,which were used as inputs in GastroPlus TM software to predict drug absorption following aerosolization of the tested formulations.BUD pharmacokinetics,estimated based on intravenous data in rats,was used to establish a drug-specific in silico absorption model.The BUD-specific in silico model revealed that drug pulmonary solubility and absorption rate constant were the key factors affecting pulmonary absorption of BUD-NC and BUD-NEM,respectively.In the case of BUD-PT,the in silico model revealed significant gastrointestinal absorption of BUD,which could be overlooked by traditional in vivo experimental observation.This study demonstrated that in vitro-in vivo-in silico approach was able to identify the key factors that influence the absorption of different inhaled formulations,which may facilitate the development of orally inhaled formulations with different drug release/absorption rates.展开更多
Budesonide is a highly potent synthetic, nonhalogenated corticosteroid. The mechanism of action of corticosteroids in allergic rhinitis remains unknown, but may involve reductions in number of various mediator cells s...Budesonide is a highly potent synthetic, nonhalogenated corticosteroid. The mechanism of action of corticosteroids in allergic rhinitis remains unknown, but may involve reductions in number of various mediator cells such as basophils, eosinophils, T-helper cells, mast cells, and neutrophils. In the nasal mucosa, nasal reactivity to allergens, and release of inflammatory mediators and proteolytic enzymes. Budesonide is very effective and quikly acting as it is rapidly and almost completely absorbed after oral administration, but has poor systemic availability (about 10%) due to extensive first-pass metabolism in the liver, mainly by the cytochrome P450 isoenzyme CYP3A4.. The major metabolites, 6-β- hydroxybudesonide and 16-α-hydroxyprednisolone have less than 1% of the glucocorticoid activity of unchanged drug with a terminal half-life of about 2 - 4 hours. Polymeric films containing Eudragit RL 100: Eudragit RS: drug (7:3:1, 7: 2:1) and Ethyl cellulose: PVP: drug (7:3:1, 7:2:1) were selected for transdermal administration based on evaluation studies. These polymeric films were prepared by mercury substrate method employing PEG-400 as plasticizer. Two different penetration enhancers Urea and Dimethyl sulphoxide (DMSO) were employed in the study. The patches in each group were uniform in drug content, thickness. In Vitro drug permeation, moisture absorption and WVTR studies were carried out on these test patches. It was found that at all humidity condition the absorption increases which were linear to the moisture absorbed. In PVA and EUDRAGIT RL 100 patches the water vapor transmission rate was found to be higher at 75% RH, RT conditions. Therefore at both % RH, RT condition the PVA and EUDRAGIT RL 100 patches provides the best resistance to water vapor. Therefore, when applied to animals (in further studies) these patches may provide more occlusion to water vapor loss from skin thus making atmosphere beneath the skin more humid that aid in drug permeation.展开更多
Objective: To study the effects of budesonide combined with gubenkechuan capsules on serum IgA, IgG, IgM, IL-17, IL-25, IL-33, Eotaxin, Periostin, NGF and T lymphocyte subgroup levels in patients with bronchial asthma...Objective: To study the effects of budesonide combined with gubenkechuan capsules on serum IgA, IgG, IgM, IL-17, IL-25, IL-33, Eotaxin, Periostin, NGF and T lymphocyte subgroup levels in patients with bronchial asthma,To provide guidance for clinical treatment of bronchial asthma. Methods: A total of 80 patients in our hospital with bronchial asthma were enrolled in this study. The subjects were divided into the control group (n=40) and the treatment group (n=40) randomly. The control group was treated with budesonide, the treatment group was treated with budesonide combined with gubenkechuan capsules, the two groups were treated for 3 months. The serum IgA, IgG, IgM, IL-17, IL-25, IL-33, Eotaxin, Periostin, NGF and peripheral blood CD3+, CD4+, CD4+/CD8+ of the two groups before and after treatment were compared. Results: There were no significantly differences of the serum IgA, IgG, IgM, IL-17, IL-25, IL-33, Eotaxin, Periostin, NGF of the two groups before treatment (P>0.05). The levels of serum IgA, IgG and IgM were higher in the two groups after treatment than before treatment. The levels of serum IL-17, IL-25, IL-33, Eotaxin, Periostin and NGF were lower than before treatment. The changes of serum IgA, IgG, IgM, IL-17, IL-25, IL-33, Eotaxin, Periostin and NGF in the experimental group after treatment were better than those in the control group (P<0.05). The levels of CD3+, CD4+, and CD4+/CD8+ in peripheral blood before and after treatment were not significantly different between the two groups (P>0.05), but the levels of CD3+, CD4+ and CD4+ / CD8+ in peripheral blood of the two groups were higher than those before treatment, and the levels of CD3+, CD4+, CD8+ and CD4+/CD8+ in peripheral blood of the experimental group were higher than those of the control group (P<0.05). Conclusion: Budesonide combined with gubenkechuan capsules for patients with bronchial asthma can reduce serum inflammatory cytokines and Eotaxin, Periostin, NGF levels,and improve the immune function of the body. It is worthy of clinical application.展开更多
Objective: To investigate the effect of budesonide and montelukast on airway function and serum inflammatory factors in children with asthma. Methods: A total of 72 children with bronchial asthma were selected as the ...Objective: To investigate the effect of budesonide and montelukast on airway function and serum inflammatory factors in children with asthma. Methods: A total of 72 children with bronchial asthma were selected as the subjects, and randomly divided into the observation group (36 cases) and the control group (36 cases). The children in the control group were treated with Budesonide Aerosol, and the observation group was treated with montelukast sodium on the basis of the control group. The airway function and the level of inflammatory factors were detected and compared between the two groups. Results: Before treatment, there was no significant difference in TEF25%, TEF50%, TEF75% and FEV1/FVC between the two groups;After treatment, the TEF25%, TEF50%, TEF75% and FEV1/FVC of the two groups were improved before treatment, and the indexes in the observation group were higher than those in the control group, the difference was statistically significant. Before treatment, the IL-4, IL-6, IL-8, IL-17, TNF- alpha levels in the two groups were not statistically different;After treatment, the levels of IL-4, IL-6, IL-8, IL-17 and TNF- in the two groups were lower than those before the treatment, and the indexes in the observation group were lower than those in the control group, and the differences were statistically significant. Conclusion: Budesonide inhalation combined with montelukast can improve the airway function and inflammatory factors in children with asthma.展开更多
Objective: To observe the clinical application of Desloratadine Citrate Disodium combined with Budesonide suspension in patients with chronic rhinosinusitis CRS after endoscopic sinus surgery, and analyze the change o...Objective: To observe the clinical application of Desloratadine Citrate Disodium combined with Budesonide suspension in patients with chronic rhinosinusitis CRS after endoscopic sinus surgery, and analyze the change of serum immunoglobulin E (IgE), eosinophils (EOS) and inflammatory factors level in patients. Method: A total of 90 cases of patients with CRS were randomly divided into control group (n=45) and observation group (n=45) according to the lottery method. Both groups were treated with endoscopic sinus surgery. On the basis of this, control group was given Budesonide suspension and observation group was treated with Desloratadine Citrate Disodium combined with Budesonide suspension. The change of serum IgE, EOS and inflammatory factors were measured before and after operation in all subjects. Results: There was no significant difference in IgE and EOS levels between control group and observation group before treatment. After treatment, the levels of serum IgE and EOS in the two groups were significantly lower than those before treatment. Moreover, after treatment, observation group was lower than control group, and the difference was significant. There was no significant difference in inflammatory factors level between control group and observation group before treatment. After treatment, the levels of serum IL-6, IL-8, TNF-α and hs-CRP were significantly lower than those before treatment. After treatment, observation group was lower than the control group in the same period, the difference was significant. Conclusion:Combined Desloratadine Citrate Disodium treatment for CRS patients on the basis of endoscopic sinus surgery and Budesonide Nasal Spray treatment, it can more effectively reduce serum IgE and EOS levels, decrease the inflammatory response. Therefore it was a potential effective treatment for patients with CRS.展开更多
Objective: To investigate the effect of budesonide combined with cetirizine hydrochloride on neurotrophic factor, airway function and chemokines CCL17 and CCL12 in patients with allergic rhinitis. Methods: A total of ...Objective: To investigate the effect of budesonide combined with cetirizine hydrochloride on neurotrophic factor, airway function and chemokines CCL17 and CCL12 in patients with allergic rhinitis. Methods: A total of 123 patients with Allergic Rhinitis were randomly divided into three groups, A group treated with budesonide nasal spray, B group treated with cetirizine hydrochloride, C group treated with budesonide combined with cetirizine hydrochloride, then the Neurotrophic factors, airway function indexes and chemokines CCL17 and CCL12 levels in three groups were compared. Results: Before the treatments, the three groups of patients in neurotrophic factor, airway function index and chemokines CCL17, CCL22 have no differences, Compared with before the treatments, after receiving different treatments, the three groups of patients in all indicators were Showed significant differences. In the indexes of neurotrophic factor (NGF, BDNF, NT-3mRNA expression), there was no significant difference between group A and group B, and group C was lower than group A and B. In airway function indexes (FVC, FEV1 and PEF), A group was significantly higher than B group, C group was significantly higher than A group;In the chemokines CCL17 and CCL22 indicators, C group was lower than A group, A group was lower than B group, the difference was significant. Conclusions: Budesonide combined with cetirizine hydrochloride in the treatment of Allergic Rhinitis, can effectively control the patients' neurotrophic factor, pulmonary ventilation and chemokine CC17, CCL22 indicators, the effect is better than Budesonide alone or Cetirizine hydrochloride.展开更多
Background There are limited studies comparing budesonide inhalation suspension(BIS)with montelukast in real-world settings where treatment adherence and persistency may be suboptimal.This real-world study aims to inv...Background There are limited studies comparing budesonide inhalation suspension(BIS)with montelukast in real-world settings where treatment adherence and persistency may be suboptimal.This real-world study aims to investigate the control effectiveness of montelukast or BIS as a monotherapy in Chinese children with mild asthma.Methods Data were derived from a retrospective questionnaire-based analysis of 2-14-year-old children with mild persistent asthma,who received either 500 pg of BIS(n=153)or 4-5 mg of montelukast(n=240)once daily.The indicators of asthma control,the Asthma Control Test(ACT)/Childhood ACT(C-ACT)score,and the asthma-related medical costs were assessed.The differences between the two groups were compared using an unpaired-t-test(normally distributed).Mann-Whitney U test(non-normally distributed)or chi-squared test(categorical variables).Results Medication compliance in the past 3-month period was better in the montelukast group than in the BIS group(P=0.042).The montelukast group exhibited better asthma control in the past 4-week period,including lower percentages of asthmatic children with symptoms more than twice a week(P=0.021),had night waking or night coughing(P=0.022),or required reliever medication more than twice a week(P<0.001).The montelukast group had a lower percentage of children with an ACT/C-ACT score≤19(P=0.015).Caregivers reported a significantly better exercise tolerance in the children who received montelukast vs.BIS in the past 12 months(P<0.001).Significantly higher medical expenditures attributable to asthma in the past 12 months were observed in the BIS group vs.montelukast group(P<0.001).Conclusion Both treatments provided acceptable overall asthma control in children with mild persistent asthma;however,more reliever medication and more medical expenditures attributable to asthma were needed for BIS vs.montelukast in real-world settings,where factors such as compliance were also taken into account.展开更多
Introduction The efficacy of inhaled budesonide for managing moderate-to-severe acute exacerbations in children is not clear.Therefore,this study aimed to evaluate hospital admission rates,need for use of systemic cor...Introduction The efficacy of inhaled budesonide for managing moderate-to-severe acute exacerbations in children is not clear.Therefore,this study aimed to evaluate hospital admission rates,need for use of systemic corticosteroids,length of hospital stay and adverse events when inhaled budesonide is added to standard pediatric emergency department management of moderate-to-severe acute exacerbations of asthma.Methods A systematic search was conducted in PubMed,Scopus,CENTRAL(Cochrane Central Register of Controlled Trials)and Google scholar databases.Randomized controlled trials that evaluated the effect of nebulized budesonide in moderate-to-severe acute exacerbations of asthma in pediatric patients were included for this meta-analysis.Statistical analysis was done using STATA version 13.0.Results A total of 16 RCTs were included.Children receiving nebulized budesonide had 43%lower risk of being hospital-ized(RR 0.57;95%CI,0.39;0.85)and 66%lower risk of requiring systemic corticosteroids(RR 0.34;95%CI,0.21;0.55)compared with those receiving placebo.There were no differences in the length of hospital stay(Hedges's g standardized mean difference-1.53;95%CI,-3.64;0.58)and risk of adverse events(RR 0.87,95%CI;0.65;1.17)between the two groups.There was no evidence of publication bias for any of the outcomes considered.Conclusion The findings of this meta-analysis support the use of inhaled budesonide in reducing risk of hospitalization and the need for systemic corticosteroids among children with acute moderate-to-severe asthma exacerbation.展开更多
Inhaled corticosteroids(ICS)and intranasal corticosteroids(INS)are the mainstays of treatment for chronic respiratory diseases like asthma,chronic obstructive pulmonary disease,and allergic rhinosinusitis.In addition,...Inhaled corticosteroids(ICS)and intranasal corticosteroids(INS)are the mainstays of treatment for chronic respiratory diseases like asthma,chronic obstructive pulmonary disease,and allergic rhinosinusitis.In addition,these localized forms of steroid therapy are generally considered to have fewer systemic side effects compared to long-term oral corticosteroids.However,concern and controversy remain over the impact of ICS and INS on the incidence and control of diabetes mellitus(DM).Given the widespread use of ICS and INS,even small individual effects on DM could lead to large consequences for the global population.Multiple large observational studies suggest that high dose ICS is associated with increased incident DM and worsened DM control,though the contribution of other risk factors is less certain.In addition,only two studies were done to investigate the association of INS and DM,with both studies demonstrating a short-term association of INS use with hyperglycemia.While more research evaluating the risk of ICS/INS for DM-related adverse events is needed,high doses of ICS/INS should be avoided when possible.The following strategies for ICS/INS dose minimization can be considered:Use of non-pharmacological measures(trigger avoidance,smoking cessation,vaccination to avoid infection),control of comorbid conditions,use of non-ICS-containing medications,intermittent rather than regular ICS dosing,and appropriate de-escalation of high ICS doses.展开更多
BACKGROUND Cough variant asthma(CVA)is one of the most common respiratory diseases in children,which has a serious impact on the quality of life and daily activities of children.For severe CVA,immunomodulatory drugs a...BACKGROUND Cough variant asthma(CVA)is one of the most common respiratory diseases in children,which has a serious impact on the quality of life and daily activities of children.For severe CVA,immunomodulatory drugs are needed.AIM To evaluate the efficacy of salmeterol combined with budesonide in the treatment of pediatric CVA.METHODS 130 children with CVA from January 2020 to December 2022 were prospectively selected and randomly divided into an observation group(salmeterol combined with budesonide)and a control group(budesonide combined with a placebo).Compare the clinical efficacy of two groups before and after intervention.The evaluation parameters include cough frequency score,nocturnal cough arousal,and lung function indicators.Serum inflammatory markers,immune function markers and airway anatomical indicators were also measured.RESULTS After the intervention,the total effective rate of the observation group was significantly higher than that of the control group,and the cough frequency score and the night cough wake rate of the observation group were lower than that of the control group,with a statistically significant difference.In addition,the changes of lung function indicators,serum markers and immune function markers in the observation group were better than those in the control group.CONCLUSION The clinical efficacy of salmeterol combined with Budesonide in the treatment of CVA is better than that of Budesonide alone.展开更多
Eosinophilic esophagitis(EoE)is an emerging chronic local immune-mediated disease of the esophagus.Beside proton pump inhibitors and food-restrictiondiets swallowed topical corticosteroids(STC)can be offered as a firs...Eosinophilic esophagitis(EoE)is an emerging chronic local immune-mediated disease of the esophagus.Beside proton pump inhibitors and food-restrictiondiets swallowed topical corticosteroids(STC)can be offered as a first line therapy according to current guidelines.This review describes the background and practical management of STCs in EoE.So far,mainly asthma inhalers containing either budesonide or fluticasone have been administered to the esophagus by swallowing these medications“off label”.Recently esophagus-targeted formulations of topical steroids have been developed showing clinicopathological response rates up to 85%-an orodispersible tablet of budesonide has been approved as the first“in label”medication for EoE in Europe in June 2018.Whereas it was shown that disease remission induction of EoE by STCs is highly effective,there is still a lack of data regarding long-term and maintenance therapy.However,current studies on STC maintenance therapy add some movement into the game.展开更多
文摘Objective:To analyze the clinical efficacy of tiotropium bromide(TB)combined with budesonide formoterol(BUD/FM)inhalation in treating chronic obstructive pulmonary disease(COPD).Methods:62 COPD patients admitted to the hospital between June 2020 and December 2022 were selected as samples for this study.The patients were divided into a combination group and a conventional group using the random number table method,with 31 cases in each group.The patients in the combination group were treated with TB combined with BUD/FM inhalation,whereas the patients in the conventional group were treated with BUD/FM inhalation only.The treatment efficacy and changes in lung function indicators of both groups were compared.Results:The total efficacy of treatment in the combined group was higher than that in the conventional group,and the difference was statistically significant(P<0.05).Before treatment,there was no difference in pulmonary function indicators between the two groups(P>0.05).After three months of treatment,all lung function indicators of the combined group were higher than those of the conventional group,and the difference was statistically significant(P<0.05).Conclusion:Combining TB with BUD/FM inhalation therapy increases the efficacy of treatment for patients with COPD.Besides,it also improves lung function and leads to a better prognosis.
文摘Objective:To analyze the effect of combined inhalation of budesonide formoterol and tiotropium bromide on arterial blood gas and pulmonary function indexes in patients with chronic obstructive pulmonary disease(COPD).Methods:100 patients with COPD treated from January to December 2022 were selected as observation objects,and were divided into a control group(n=50,in which budesonide and formoterol were administered)and an experimental group(n=50,the treatment drug was budesonide formoterol combined with tiotropium bromide)according to the computer grouping method,and compared the treatment results.Results:(i)Before treatment,there was no difference in the partial pressure of carbon dioxide and partial pressure of oxygen between the control group and the experimental group(P>0.05);after treatment,the partial pressure of carbon dioxide and partial pressure of oxygen in the experimental group were higher than those in the control group,with significant differences(P<0.05).(ii)Before treatment,there was no difference in forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC between the control group and the experimental group(P>0.05);after treatment,the FVC,FEV1,and FEV1/FVC in the experimental group were significantly higher than those in the control group(P<0.05).(iii)There was no difference in the levels of CRP,IL-6,and TNF-αbetween the control group and the experimental group(P>0.05);after treatment,the levels of CRP,IL-6,and TNF-αin the experimental group were lower than those in the control group,with significant differences(P<0.05).(iv)Compared to the total incidence of adverse reactions in the control group(28.00%),the incidence of total adverse reactions in the experimental group was lower at 10.00%,and the difference was significant(P<0.05).Conclusion:The combined inhalation of budesonide and formoterol with tiotropium bromide has demonstrated a clear therapeutic efficacy and safety in treating chronic obstructive pulmonary disease.This treatment approach effectively enhances arterial blood gas levels and lung function,showing promising potential for widespread application.
文摘Objective:To explore and analyze the effect of nebulized budesonide inhalation on children with asthma and its influence on immune indexes.Methods:300 children who were with asthma admitted to the Pediatric Respiratory Department of our hospital from January 2021 to January 2023 were selected as the research subjects.The patients were divided into a nebulization group(n=150)and a reference group(n=150)by drawing lots.The nebulization group received routine treatment along with budesonide nebulization inhalation therapy,while the reference group only received routine treatment.The treatment effect,the immune indicators,the time taken for the disappearance of symptoms,and the pulmonary function indicators of both groups were compared.Results:The total efficacy of treatment received in the nebulization group was significantly higher than that in the reference group(P<0.05).Before treatment,there was no statistically significant difference in the CD4^(+),CD8^(+),CD4^(+)/CD8^(+),between the two groups(P>0.05);after treatment,the nebulization group’s CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and other immune indicators were significantly better than the reference group(P<0.05).The time taken for the disappearance of symptoms like wheezing,coughing,crackles,shortness of breath,and other symptoms in the nebulization group was significantly shorter than in the reference group(P<0.05).Before treatment,there was no statistically significant difference in the pulmonary function indexes such as FEV1,PEF,and FVC between the two groups(P>0.05);after treatment,the pulmonary function indexes of the patients in the nebulization group were significantly better than those in the reference group(P<0.05).Conclusion:Nebulized budesonide inhalation therapy has shown significant efficacy in the treatment of pediatric asthma,with notable improvements in immune indicators.Therefore,it is worthy of recommendation and further promotion.
文摘Budesonide is a corticosteroid used for the treatment of asthma via various matrices and inhalation mechanisms. An unknown peak of Budesonide aqueous formulation has been investigated during stability study wherein the impurity level observed around 0.1% well below the threshold 0.5%. The approach to identify anonymous species was adopted as first to generate the impurity in sample, isolate, enrich and was subjected to LC-MS/MS and NMR for spectral studies. Based on the spectral data the anonymous species were identified as a “Lumibudesonide’’ ((5aR,5bS,5cS,6S,7aS,7bS,10aR,11aS,11bS)-6-hydroxy-7b-(2-hydroxyacetyl)-5b,7a-dimethyl-9-propyl 1,5a,5b,5c,6,7,7a,7b,10a,11,11a,11b dodecahydrocyclopenta[2'',3'']cyclopropa [1'',2'':3', 4']benzo [1',2':4,5]indeno [1,2-d][1,3]dioxol-5(2H)-one), which is observed in photolysis of Budesonide.
文摘Eosinophilic cholangitis is a rare cause of deranged obstructive liver function tests. It has been described as a great mimicker for malignant biliary strictures and bile duct obstruction. There are only case reports available on treatment experience for eosinophilic cholangitis. A large proportion of patients present with biliary strictures for which they have undergone surgery or endoscopic treatment and a small proportion was given systemic corticosteroid. We share our treatment experience using budesonide which has fewer systemic side effects to prednisolone and avoids invasive management.
文摘Purpose: Since intravesically administered steroid therapy may treat bladder pain syndrome/interstitial cystitis (BPS/IC) with fewer side effects than the current treatment of orally administered steroids, we investigated whether the intravesical infusion of budesonide foam can effectively treat BPS/IC symptoms in a rat model of tranilast-induced BPS/IC. Methods: There were 6 rat treatment groups (n = 8 per group): control + single or daily saline infusion, tranilast + single or daily saline infusion, and tranilast + single or daily budesonide infusion. All groups except for the controls were fed a tranilast supplemented diet for 5 weeks. Budesonide and saline were infused intravesically. After the BPS/IC rat model underwent single infusion treatments, we measured the paw pain threshold using the von Frey test and continuous cystometry was taken. After two weeks of daily intravesical infusions, we measured locomotor activity and serum cortisol levels;harvested bladders underwent histological analysis. Results: Both pain threshold and locomotor activity were significantly lower in the saline-infused groups receiving the tranilast diet, but there were no differences between the budesonide-infused groups and the controls. The interval between bladder contractions was significantly shorter in the tranilast group than the control or tranilast + budesonide infusion groups. The serum cortisol levels did not change. Hematoxylin-Eosin stainings of the bladder showed thickening of the bladder muscle layer and mucosal edema in the tranilast group, while the tranilast + budesonide infusion group showed only mild changes. Conclusion: Intravesical infusion of budesonide effectively treated BPS/IC symptoms in a rat model of BPS/IC.
文摘Objective:To study the influence of budesonide and salbutamol atomization inhalation on Th17/Treg balance in patients with bronchial asthma and its correlation with airway remodeling.Methods:A total of 90 patients with bronchial asthma who received systemic treatment in our hospital between July 2013 and April 2016 were divided into control group (n=45) and observation group (n=45) according to random number table. Patients in the control group were treated with salbutamol atomization inhalation alone while those in observation group were treated with budesonide and salbutamol atomization inhalation. The Th17/Treg ratio in peripheral blood as well as serum contents of airway remodeling-related indicators was compared between two groups before and after treatment. The correlation between Th17/Treg balance and airway remodeling in patients with bronchial asthma was detected by Pearson test. Results:Before treatment, the differences in peripheral blood Th17/Treg ratio as well as serum contents of inflammatory mediators, growth factor indexes and collagen metabolism indexes were not statistically significant between two groups of patients. After treatment, peripheral blood Th17/Treg ratio in observation group was lower than that in control group, serum CRP, IL-8, IL-13 and TNF- contents in observation group were lower than those in control group, serum PDGF-BB, b-FGF and VEGF contents in observation group were lower than those in control group, and serum HA, PCⅢ and LN contents in observation group were lower than those in control group. The Th17/Treg ratio in patients with bronchial asthma after treatment was positively correlated with the levels of airway remodeling-related indexes.Conclusion:Budesonide combined with salbutamol atomization inhalation can optimize the Th17/Treg balance in patients with bronchial asthma, and Th17/Treg is directly correlated to the degree of airway remodeling.
文摘Objective: To investigate the effects of montelukast sodium combined with budesonide on pulmonary function, inflammatory factors and immunoglobulin in children with asthma. Methods: A total of 100 children with asthma treated in our hospital from May 2013 to November 2016 were randomly divided into control group and observation group. In the control group, budesonide inhalation therapy was given. On the basis of the control group, montelukast sodium treatment was given, pulmonary function, inflammatory factors and immunoglobulin levels in the two groups before and after treatment were measured. Results:Compared with before treatment, the levels of FEV1%, FEF50%, FEF25% and PEF% in the two groups were significantly increased, those in the observation group were higher than in control group;compared with before treatment, IL-10 levels were significantly increased, TNF-α and IL-8 levels were significantly decreased in the two groups after treatment, moreover those in the observation group IL-10 levels were significantly higher than the control group, TNF-α and IL-8 were significantly lower than those in the control group, the difference was statistically significant;Compared with before treatment, IgA and IgM levels were significantly increased in both groups after treatment, IgE levels were significantly decreased, and IgA and IgM levels in the observation group were significantly higher than in the control group, IgE levels were significantly lower than the control group, the difference was statistically. Conclusion: Montelukast sodium combined with budesonide can effectively reduce the inflammation level of children with asthma, improve lung function, enhance immunity, the effect is significant, it is worth further clinical application.
文摘Objective: To study the effects of oral cetirizine combined with budesonide inhalation on immune inflammatory response in children with acute asthma attack. Methods: Children with acute asthma attack who were treated in Beijing Luhe Hospital Affiliated to Capital Medical University between April 2014 and February 2017 were selected and randomly divided into two groups, observation group received oral cetirizine combined with budesonide inhalation therapy, and control group received budesonide inhalation therapy. The contents of CD4+T cell subsets and the expression of immune transcription factors in peripheral blood as well as the contents of CD4+T cytokines and inflammatory mediators in serum were measured after 1 week of treatment. Results: After 1 week of treatment, Th1 and Treg contents as well as BCL11B, STAT4 and SOCS3 mRNA expression in peripheral blood as well as IFN-γand IL-10 contents in serum of observation group were greatly higher than those of control group while Th2, Th17 and Th22 contents as well as STAT1 and STAT3 mRNA expression in peripheral blood as well as IL-4, IL-17, IL-22, HMGB1, Periostin, Eotaxin and ADAM33 contents in serum were greatly lower than those of control group. Conclusion: Oral cetirizine combined with budesonide inhalation is more effective than budesonide inhalation alone to modulate the immune inflammatory response in children with acute asthma attack.
基金This work was supported by National Natural Science Foundation of China(Nos.81302720 and No.81573380)Liaoning Pan Deng Xue Zhe Scholarship+1 种基金supported by the Ministry of Education,Science and Technological Development,Republic of Serbia(grant number 451-03-68/2020-14/200161)Cun D.is grateful to Liaoning Provincial Education officer’s Excellent Talents Supporting Plan for financial support.
文摘This study aims to understand the absorption patterns of three different kinds of inhaled formulations via in silico modeling using budesonide(BUD)as a model drug.The formulations investigated in this study are:(i)commercially available micronized BUD mixed with lactose(BUD-PT),(ii)BUD nanocrystal suspension(BUD-NC),(iii)BUD nanocrystals embedded hyaluronic acid microparticles(BUD-NEM).The deposition patterns of the three inhaled formulations in the rats’lungs were determined in vivo and in silico predicted,which were used as inputs in GastroPlus TM software to predict drug absorption following aerosolization of the tested formulations.BUD pharmacokinetics,estimated based on intravenous data in rats,was used to establish a drug-specific in silico absorption model.The BUD-specific in silico model revealed that drug pulmonary solubility and absorption rate constant were the key factors affecting pulmonary absorption of BUD-NC and BUD-NEM,respectively.In the case of BUD-PT,the in silico model revealed significant gastrointestinal absorption of BUD,which could be overlooked by traditional in vivo experimental observation.This study demonstrated that in vitro-in vivo-in silico approach was able to identify the key factors that influence the absorption of different inhaled formulations,which may facilitate the development of orally inhaled formulations with different drug release/absorption rates.
文摘Budesonide is a highly potent synthetic, nonhalogenated corticosteroid. The mechanism of action of corticosteroids in allergic rhinitis remains unknown, but may involve reductions in number of various mediator cells such as basophils, eosinophils, T-helper cells, mast cells, and neutrophils. In the nasal mucosa, nasal reactivity to allergens, and release of inflammatory mediators and proteolytic enzymes. Budesonide is very effective and quikly acting as it is rapidly and almost completely absorbed after oral administration, but has poor systemic availability (about 10%) due to extensive first-pass metabolism in the liver, mainly by the cytochrome P450 isoenzyme CYP3A4.. The major metabolites, 6-β- hydroxybudesonide and 16-α-hydroxyprednisolone have less than 1% of the glucocorticoid activity of unchanged drug with a terminal half-life of about 2 - 4 hours. Polymeric films containing Eudragit RL 100: Eudragit RS: drug (7:3:1, 7: 2:1) and Ethyl cellulose: PVP: drug (7:3:1, 7:2:1) were selected for transdermal administration based on evaluation studies. These polymeric films were prepared by mercury substrate method employing PEG-400 as plasticizer. Two different penetration enhancers Urea and Dimethyl sulphoxide (DMSO) were employed in the study. The patches in each group were uniform in drug content, thickness. In Vitro drug permeation, moisture absorption and WVTR studies were carried out on these test patches. It was found that at all humidity condition the absorption increases which were linear to the moisture absorbed. In PVA and EUDRAGIT RL 100 patches the water vapor transmission rate was found to be higher at 75% RH, RT conditions. Therefore at both % RH, RT condition the PVA and EUDRAGIT RL 100 patches provides the best resistance to water vapor. Therefore, when applied to animals (in further studies) these patches may provide more occlusion to water vapor loss from skin thus making atmosphere beneath the skin more humid that aid in drug permeation.
文摘Objective: To study the effects of budesonide combined with gubenkechuan capsules on serum IgA, IgG, IgM, IL-17, IL-25, IL-33, Eotaxin, Periostin, NGF and T lymphocyte subgroup levels in patients with bronchial asthma,To provide guidance for clinical treatment of bronchial asthma. Methods: A total of 80 patients in our hospital with bronchial asthma were enrolled in this study. The subjects were divided into the control group (n=40) and the treatment group (n=40) randomly. The control group was treated with budesonide, the treatment group was treated with budesonide combined with gubenkechuan capsules, the two groups were treated for 3 months. The serum IgA, IgG, IgM, IL-17, IL-25, IL-33, Eotaxin, Periostin, NGF and peripheral blood CD3+, CD4+, CD4+/CD8+ of the two groups before and after treatment were compared. Results: There were no significantly differences of the serum IgA, IgG, IgM, IL-17, IL-25, IL-33, Eotaxin, Periostin, NGF of the two groups before treatment (P>0.05). The levels of serum IgA, IgG and IgM were higher in the two groups after treatment than before treatment. The levels of serum IL-17, IL-25, IL-33, Eotaxin, Periostin and NGF were lower than before treatment. The changes of serum IgA, IgG, IgM, IL-17, IL-25, IL-33, Eotaxin, Periostin and NGF in the experimental group after treatment were better than those in the control group (P<0.05). The levels of CD3+, CD4+, and CD4+/CD8+ in peripheral blood before and after treatment were not significantly different between the two groups (P>0.05), but the levels of CD3+, CD4+ and CD4+ / CD8+ in peripheral blood of the two groups were higher than those before treatment, and the levels of CD3+, CD4+, CD8+ and CD4+/CD8+ in peripheral blood of the experimental group were higher than those of the control group (P<0.05). Conclusion: Budesonide combined with gubenkechuan capsules for patients with bronchial asthma can reduce serum inflammatory cytokines and Eotaxin, Periostin, NGF levels,and improve the immune function of the body. It is worthy of clinical application.
文摘Objective: To investigate the effect of budesonide and montelukast on airway function and serum inflammatory factors in children with asthma. Methods: A total of 72 children with bronchial asthma were selected as the subjects, and randomly divided into the observation group (36 cases) and the control group (36 cases). The children in the control group were treated with Budesonide Aerosol, and the observation group was treated with montelukast sodium on the basis of the control group. The airway function and the level of inflammatory factors were detected and compared between the two groups. Results: Before treatment, there was no significant difference in TEF25%, TEF50%, TEF75% and FEV1/FVC between the two groups;After treatment, the TEF25%, TEF50%, TEF75% and FEV1/FVC of the two groups were improved before treatment, and the indexes in the observation group were higher than those in the control group, the difference was statistically significant. Before treatment, the IL-4, IL-6, IL-8, IL-17, TNF- alpha levels in the two groups were not statistically different;After treatment, the levels of IL-4, IL-6, IL-8, IL-17 and TNF- in the two groups were lower than those before the treatment, and the indexes in the observation group were lower than those in the control group, and the differences were statistically significant. Conclusion: Budesonide inhalation combined with montelukast can improve the airway function and inflammatory factors in children with asthma.
文摘Objective: To observe the clinical application of Desloratadine Citrate Disodium combined with Budesonide suspension in patients with chronic rhinosinusitis CRS after endoscopic sinus surgery, and analyze the change of serum immunoglobulin E (IgE), eosinophils (EOS) and inflammatory factors level in patients. Method: A total of 90 cases of patients with CRS were randomly divided into control group (n=45) and observation group (n=45) according to the lottery method. Both groups were treated with endoscopic sinus surgery. On the basis of this, control group was given Budesonide suspension and observation group was treated with Desloratadine Citrate Disodium combined with Budesonide suspension. The change of serum IgE, EOS and inflammatory factors were measured before and after operation in all subjects. Results: There was no significant difference in IgE and EOS levels between control group and observation group before treatment. After treatment, the levels of serum IgE and EOS in the two groups were significantly lower than those before treatment. Moreover, after treatment, observation group was lower than control group, and the difference was significant. There was no significant difference in inflammatory factors level between control group and observation group before treatment. After treatment, the levels of serum IL-6, IL-8, TNF-α and hs-CRP were significantly lower than those before treatment. After treatment, observation group was lower than the control group in the same period, the difference was significant. Conclusion:Combined Desloratadine Citrate Disodium treatment for CRS patients on the basis of endoscopic sinus surgery and Budesonide Nasal Spray treatment, it can more effectively reduce serum IgE and EOS levels, decrease the inflammatory response. Therefore it was a potential effective treatment for patients with CRS.
文摘Objective: To investigate the effect of budesonide combined with cetirizine hydrochloride on neurotrophic factor, airway function and chemokines CCL17 and CCL12 in patients with allergic rhinitis. Methods: A total of 123 patients with Allergic Rhinitis were randomly divided into three groups, A group treated with budesonide nasal spray, B group treated with cetirizine hydrochloride, C group treated with budesonide combined with cetirizine hydrochloride, then the Neurotrophic factors, airway function indexes and chemokines CCL17 and CCL12 levels in three groups were compared. Results: Before the treatments, the three groups of patients in neurotrophic factor, airway function index and chemokines CCL17, CCL22 have no differences, Compared with before the treatments, after receiving different treatments, the three groups of patients in all indicators were Showed significant differences. In the indexes of neurotrophic factor (NGF, BDNF, NT-3mRNA expression), there was no significant difference between group A and group B, and group C was lower than group A and B. In airway function indexes (FVC, FEV1 and PEF), A group was significantly higher than B group, C group was significantly higher than A group;In the chemokines CCL17 and CCL22 indicators, C group was lower than A group, A group was lower than B group, the difference was significant. Conclusions: Budesonide combined with cetirizine hydrochloride in the treatment of Allergic Rhinitis, can effectively control the patients' neurotrophic factor, pulmonary ventilation and chemokine CC17, CCL22 indicators, the effect is better than Budesonide alone or Cetirizine hydrochloride.
基金supported by MSD China,Shanghai,China(grant number:50146).
文摘Background There are limited studies comparing budesonide inhalation suspension(BIS)with montelukast in real-world settings where treatment adherence and persistency may be suboptimal.This real-world study aims to investigate the control effectiveness of montelukast or BIS as a monotherapy in Chinese children with mild asthma.Methods Data were derived from a retrospective questionnaire-based analysis of 2-14-year-old children with mild persistent asthma,who received either 500 pg of BIS(n=153)or 4-5 mg of montelukast(n=240)once daily.The indicators of asthma control,the Asthma Control Test(ACT)/Childhood ACT(C-ACT)score,and the asthma-related medical costs were assessed.The differences between the two groups were compared using an unpaired-t-test(normally distributed).Mann-Whitney U test(non-normally distributed)or chi-squared test(categorical variables).Results Medication compliance in the past 3-month period was better in the montelukast group than in the BIS group(P=0.042).The montelukast group exhibited better asthma control in the past 4-week period,including lower percentages of asthmatic children with symptoms more than twice a week(P=0.021),had night waking or night coughing(P=0.022),or required reliever medication more than twice a week(P<0.001).The montelukast group had a lower percentage of children with an ACT/C-ACT score≤19(P=0.015).Caregivers reported a significantly better exercise tolerance in the children who received montelukast vs.BIS in the past 12 months(P<0.001).Significantly higher medical expenditures attributable to asthma in the past 12 months were observed in the BIS group vs.montelukast group(P<0.001).Conclusion Both treatments provided acceptable overall asthma control in children with mild persistent asthma;however,more reliever medication and more medical expenditures attributable to asthma were needed for BIS vs.montelukast in real-world settings,where factors such as compliance were also taken into account.
文摘Introduction The efficacy of inhaled budesonide for managing moderate-to-severe acute exacerbations in children is not clear.Therefore,this study aimed to evaluate hospital admission rates,need for use of systemic corticosteroids,length of hospital stay and adverse events when inhaled budesonide is added to standard pediatric emergency department management of moderate-to-severe acute exacerbations of asthma.Methods A systematic search was conducted in PubMed,Scopus,CENTRAL(Cochrane Central Register of Controlled Trials)and Google scholar databases.Randomized controlled trials that evaluated the effect of nebulized budesonide in moderate-to-severe acute exacerbations of asthma in pediatric patients were included for this meta-analysis.Statistical analysis was done using STATA version 13.0.Results A total of 16 RCTs were included.Children receiving nebulized budesonide had 43%lower risk of being hospital-ized(RR 0.57;95%CI,0.39;0.85)and 66%lower risk of requiring systemic corticosteroids(RR 0.34;95%CI,0.21;0.55)compared with those receiving placebo.There were no differences in the length of hospital stay(Hedges's g standardized mean difference-1.53;95%CI,-3.64;0.58)and risk of adverse events(RR 0.87,95%CI;0.65;1.17)between the two groups.There was no evidence of publication bias for any of the outcomes considered.Conclusion The findings of this meta-analysis support the use of inhaled budesonide in reducing risk of hospitalization and the need for systemic corticosteroids among children with acute moderate-to-severe asthma exacerbation.
文摘Inhaled corticosteroids(ICS)and intranasal corticosteroids(INS)are the mainstays of treatment for chronic respiratory diseases like asthma,chronic obstructive pulmonary disease,and allergic rhinosinusitis.In addition,these localized forms of steroid therapy are generally considered to have fewer systemic side effects compared to long-term oral corticosteroids.However,concern and controversy remain over the impact of ICS and INS on the incidence and control of diabetes mellitus(DM).Given the widespread use of ICS and INS,even small individual effects on DM could lead to large consequences for the global population.Multiple large observational studies suggest that high dose ICS is associated with increased incident DM and worsened DM control,though the contribution of other risk factors is less certain.In addition,only two studies were done to investigate the association of INS and DM,with both studies demonstrating a short-term association of INS use with hyperglycemia.While more research evaluating the risk of ICS/INS for DM-related adverse events is needed,high doses of ICS/INS should be avoided when possible.The following strategies for ICS/INS dose minimization can be considered:Use of non-pharmacological measures(trigger avoidance,smoking cessation,vaccination to avoid infection),control of comorbid conditions,use of non-ICS-containing medications,intermittent rather than regular ICS dosing,and appropriate de-escalation of high ICS doses.
文摘BACKGROUND Cough variant asthma(CVA)is one of the most common respiratory diseases in children,which has a serious impact on the quality of life and daily activities of children.For severe CVA,immunomodulatory drugs are needed.AIM To evaluate the efficacy of salmeterol combined with budesonide in the treatment of pediatric CVA.METHODS 130 children with CVA from January 2020 to December 2022 were prospectively selected and randomly divided into an observation group(salmeterol combined with budesonide)and a control group(budesonide combined with a placebo).Compare the clinical efficacy of two groups before and after intervention.The evaluation parameters include cough frequency score,nocturnal cough arousal,and lung function indicators.Serum inflammatory markers,immune function markers and airway anatomical indicators were also measured.RESULTS After the intervention,the total effective rate of the observation group was significantly higher than that of the control group,and the cough frequency score and the night cough wake rate of the observation group were lower than that of the control group,with a statistically significant difference.In addition,the changes of lung function indicators,serum markers and immune function markers in the observation group were better than those in the control group.CONCLUSION The clinical efficacy of salmeterol combined with Budesonide in the treatment of CVA is better than that of Budesonide alone.
文摘Eosinophilic esophagitis(EoE)is an emerging chronic local immune-mediated disease of the esophagus.Beside proton pump inhibitors and food-restrictiondiets swallowed topical corticosteroids(STC)can be offered as a first line therapy according to current guidelines.This review describes the background and practical management of STCs in EoE.So far,mainly asthma inhalers containing either budesonide or fluticasone have been administered to the esophagus by swallowing these medications“off label”.Recently esophagus-targeted formulations of topical steroids have been developed showing clinicopathological response rates up to 85%-an orodispersible tablet of budesonide has been approved as the first“in label”medication for EoE in Europe in June 2018.Whereas it was shown that disease remission induction of EoE by STCs is highly effective,there is still a lack of data regarding long-term and maintenance therapy.However,current studies on STC maintenance therapy add some movement into the game.
