The impact of budesonide inhalation suspension for asthma hospitalization: In terms of length of stay, recovery time from symptoms, and hospitalization costs.

BACKGROUND: Hospitalization is a major cause of medical expenditure for asthma. Budesonide inhalation suspension (BIS) may assist in reducing asthma-related symptoms in severe asthma exacerbation. However, its effectiveness for hospitalized patients remains poorly known. The objective of this study is to determine associations of BIS with asthma hospitalization. METHODS: We retrospectively analyzed 98 patients who were admitted to our hospital due to severe asthma exacerbation (24 treated with BIS in combination with procaterol) from April 2014 to January 2019. Length of stay, recovery time from symptoms (wheezes), and hospitalization costs were compared between the 2 groups according to clinical factors including the use of BIS and sings of respiratory infections (i.e. C-reactive protein, the presence of phlegm, and the use of antibiotics). Multivariate logistic regression analysis was performed to determine factors contributing to hospitalization outcomes. RESULTS: The use of BIS was associated with shorter length of stay, faster recovery time from symptoms, and more reduced hospitalization costs (6.0 vs 8.5 days, 2.5 vs 5.0 days, and 258,260 vs 343,350 JPY). Signs of respiratory infection were also associated with hospitalization outcomes. On a multivariate regression analysis, the use of BIS was a determinant of shortened length of stay and reduced symptoms and medical costs for asthma hospitalization along with signs of respiratory infection. CONCLUSIONS: BIS may contribute to shorten length of hospital stay and to reduce symptoms and medical expenditure irrespective of the presence or absence of respiratory infection.

The Observation of Curative Effect on Leukotriene Receptor Antagonist Combined with Inhaled Hormone in the Treatment of Moderately Severe Asthma / 昆明医科大学学报

Objective To explore the clinical efficacy of Montelukast in the treatment of severe asthma. Methods A retrospective analysis was conducted in the Department of Respiratory Medicine from January 2016 to August 2017.A total of 168 patients with moderately severe asthma were randomly divided into control group and observation group. The control group was treated with leukotriene receptor antagonist Montelukast and the observation group was treated with both Montelukast and budesonide inhalation suspension. Then we compared the clinical effect, lung function and blood gas index before and after treatment between the two groups. Results Significant improvement was observed in the clinical symptoms and lung function in the two groups of patients after the treatment. Compared to the control group, a better improvement was seen in the observation group (P＜0.05) . The results of blood gas analysis were significantly different between the two groups before and after the treatment (P＜0.05) . Conclusion In the treatment of moderately severe asthma, Montelukast combined with budesonide inhalation suspension has good clinical effect and can significantly alleviate symptoms, which can be widely used clinically.

Budesonide inhalation suspension versus montelukast in children aged 2 to 4 years with mild persistent asthma.

BACKGROUND: Budesonide inhalation suspension (BIS) and montelukast provide acceptable asthma control, whereas overall measures favored BIS in children aged 2 to 8 years with mild persistent asthma. OBJECTIVE: We compared BIS and montelukast over a 1-year period in children aged 2 to 4 years with asthma. METHODS: Data were derived from a 52-week, open-label, randomized, active-controlled, multicenter study (NCT00641472). Children with mild asthma received either BIS 0.5 mg or montelukast 4 to 5 mg once daily. Patients were stepped up to twice-daily BIS or oral corticosteroids for mild or severe asthma worsening, respectively. Primary efficacy assessment was time to first additional asthma medication for exacerbation over 52 weeks. RESULTS: Two hundred two patients, age 2 to 4 years, received BIS (n = 105) or montelukast (n = 97). No difference was observed between the BIS and montelukast groups in median time to first additional asthma medication over 52 weeks (183 vs 86 days). Statistically significant differences were observed in favor of BIS over montelukast in the percentage of patients requiring oral steroids at 52 weeks (21.9% vs 37.1%; P = .022), the rate (number/patient/year) of additional courses of medication (1.35 vs 2.30; P = .003), the rate of additional oral steroid therapy (0.44 vs 0.88; P = .008), and caregivers' ability to manage the patient's symptoms (P = .026). Both treatments were well tolerated. CONCLUSION: BIS and montelukast provided acceptable asthma control in children aged 2 to 4 years with mild persistent asthma with no significant difference between treatments in the primary end point; however, several secondary outcomes showed statistically significant differences (and many had numerical differences) in favor of BIS over montelukast.