#Budesonide Multimatrix Is Efficacious for Mesalamine-refractory, Mild to Moderate Ulcerative #Colitis: A Randomised, Placebo-controlled Trial
https://academic.oup.com/ecco-jcc/article-abstract/doi/10.1093/ecco-jcc/jjx032/3061890/Budesonide-Multimatrix-Is-Efficacious-for?redirectedFrom=fulltext
Budesonide multimatrix was safe and efficacious for inducing clinical and endoscopic remission for mild to moderate ulcerative colitis refractory to oral mesalamine therapy.
https://academic.oup.com/ecco-jcc/article-abstract/doi/10.1093/ecco-jcc/jjx032/3061890/Budesonide-Multimatrix-Is-Efficacious-for?redirectedFrom=fulltext
Budesonide multimatrix was safe and efficacious for inducing clinical and endoscopic remission for mild to moderate ulcerative colitis refractory to oral mesalamine therapy.
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As-Needed Budesonide–Formoterol versus Maintenance #Budesonide in Mild #Asthma
https://www.nejm.org/doi/full/10.1056/NEJMoa1715275
.. Budesonide–formoterol used as needed was noninferior to budesonide maintenance therapy for severe exacerbations; the annualized rate of severe exacerbations was 0.11 (95% confidence interval CI, 0.10 to 0.13) and 0.12 (95% CI, 0.10 to 0.14), respectively (rate ratio, 0.97; upper one-sided 95% confidence limit, 1.16). The median daily metered dose of inhaled glucocorticoid was lower in the budesonide–formoterol group (66 μg) than in the budesonide maintenance group (267 μg). The time to the first exacerbation was similar in the two groups (hazard ratio, 0.96; 95% CI, 0.78 to 1.17). The change in ACQ-5 score showed a difference of 0.11 units (95% CI, 0.07 to 0.15) in favor of budesonide maintenance therapy.
CONCLUSIONS
In patients with mild asthma, budesonide–formoterol used as needed was noninferior to twice-daily budesonide with respect to the rate of severe asthma exacerbations during 52 weeks of treatment but was inferior in controlling symptoms. Patients in the budesonide–formoterol group had approximately one quarter of the inhaled glucocorticoid exposure of those in the budesonide maintenance group
As-Needed Budesonide–Formoterol versus Maintenance #Budesonide in Mild #Asthma
https://www.nejm.org/doi/full/10.1056/NEJMoa1715275
.. Budesonide–formoterol used as needed was noninferior to budesonide maintenance therapy for severe exacerbations; the annualized rate of severe exacerbations was 0.11 (95% confidence interval CI, 0.10 to 0.13) and 0.12 (95% CI, 0.10 to 0.14), respectively (rate ratio, 0.97; upper one-sided 95% confidence limit, 1.16). The median daily metered dose of inhaled glucocorticoid was lower in the budesonide–formoterol group (66 μg) than in the budesonide maintenance group (267 μg). The time to the first exacerbation was similar in the two groups (hazard ratio, 0.96; 95% CI, 0.78 to 1.17). The change in ACQ-5 score showed a difference of 0.11 units (95% CI, 0.07 to 0.15) in favor of budesonide maintenance therapy.
CONCLUSIONS
In patients with mild asthma, budesonide–formoterol used as needed was noninferior to twice-daily budesonide with respect to the rate of severe asthma exacerbations during 52 weeks of treatment but was inferior in controlling symptoms. Patients in the budesonide–formoterol group had approximately one quarter of the inhaled glucocorticoid exposure of those in the budesonide maintenance group
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Efficacy of Budesonide vs Fluticasone for Initial Treatment of Eosinophilic Esophagitis in a Randomized Controlled Trial
https://www.gastrojournal.org/article/S0016-5085(19)33555-3/fulltext?mobileUi=0
Topical steroid treatments for eosinophilic #esophagitis (EoE) include swallowed #fluticasone from a multi-dose inhaler (MDI) or oral viscous #budesonide (OVB) slurry, but the two have never been compared.
In a modified intention-to-treat analysis, the subjects had baseline peak eosinophil counts of 73 and 77 eos/hpf in the OVB and MDI groups, respectively, and DSQ scores of 11 and 8. Post-treatment eosinophil counts were 15 and 21 in the OVB and MDI groups, respectively (P=.31), with 71% and 64% achieving histologic response (P=.38). DSQ scores were 5 and 4 in the OVB and MDI groups (P=.70). Similar trends were noted for post-treatment total EoE endoscopic reference scores (2 vs 3; P=.06). Esophageal candidiasis developed in 12% of patients receiving OVB and 16% receiving MDI; oral thrush was observed in 3% and 2%, respectively.
Conclusion
In a randomized clinical trial, initial treatment of EoE with either OVB or fluticasone MDI produced a significant decrease in esophageal eosinophil counts and improved dysphagia and endoscopic features. However, OVB was not superior to MDI, so either is an acceptable treatment for EoE.
Efficacy of Budesonide vs Fluticasone for Initial Treatment of Eosinophilic Esophagitis in a Randomized Controlled Trial
https://www.gastrojournal.org/article/S0016-5085(19)33555-3/fulltext?mobileUi=0
Topical steroid treatments for eosinophilic #esophagitis (EoE) include swallowed #fluticasone from a multi-dose inhaler (MDI) or oral viscous #budesonide (OVB) slurry, but the two have never been compared.
In a modified intention-to-treat analysis, the subjects had baseline peak eosinophil counts of 73 and 77 eos/hpf in the OVB and MDI groups, respectively, and DSQ scores of 11 and 8. Post-treatment eosinophil counts were 15 and 21 in the OVB and MDI groups, respectively (P=.31), with 71% and 64% achieving histologic response (P=.38). DSQ scores were 5 and 4 in the OVB and MDI groups (P=.70). Similar trends were noted for post-treatment total EoE endoscopic reference scores (2 vs 3; P=.06). Esophageal candidiasis developed in 12% of patients receiving OVB and 16% receiving MDI; oral thrush was observed in 3% and 2%, respectively.
Conclusion
In a randomized clinical trial, initial treatment of EoE with either OVB or fluticasone MDI produced a significant decrease in esophageal eosinophil counts and improved dysphagia and endoscopic features. However, OVB was not superior to MDI, so either is an acceptable treatment for EoE.
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Controlled Trial of #Budesonide– #Formoterol as Needed for Mild #Asthma
https://www.nejm.org/doi/full/10.1056/NEJMoa1901963
In double-blind, placebo-controlled trials, budesonide–formoterol used on an as-needed basis resulted in a lower risk of severe exacerbation of asthma than as-needed use of a short-acting β2-agonist (SABA); the risk was similar to that of budesonide maintenance therapy plus as-needed SABA..
..The number of severe exacerbations was lower in the budesonide–formoterol group than in both the albuterol group (9 vs. 23; relative risk, 0.40; 95% CI, 0.18 to 0.86) and the budesonide maintenance group (9 vs. 21; relative risk, 0.44; 95% CI, 0.20 to 0.96). The mean (±SD) dose of inhaled budesonide was 107±109 μg per day in the budesonide–formoterol group and 222±113 μg per day in the budesonide maintenance group. The incidence and type of adverse events reported were consistent with those in previous trials and with reports in clinical use.
CONCLUSIONS
In an open-label trial involving adults with mild asthma, budesonide–formoterol used as needed was superior to albuterol used as needed for the prevention of asthma exacerbations.
Controlled Trial of #Budesonide– #Formoterol as Needed for Mild #Asthma
https://www.nejm.org/doi/full/10.1056/NEJMoa1901963
In double-blind, placebo-controlled trials, budesonide–formoterol used on an as-needed basis resulted in a lower risk of severe exacerbation of asthma than as-needed use of a short-acting β2-agonist (SABA); the risk was similar to that of budesonide maintenance therapy plus as-needed SABA..
..The number of severe exacerbations was lower in the budesonide–formoterol group than in both the albuterol group (9 vs. 23; relative risk, 0.40; 95% CI, 0.18 to 0.86) and the budesonide maintenance group (9 vs. 21; relative risk, 0.44; 95% CI, 0.20 to 0.96). The mean (±SD) dose of inhaled budesonide was 107±109 μg per day in the budesonide–formoterol group and 222±113 μg per day in the budesonide maintenance group. The incidence and type of adverse events reported were consistent with those in previous trials and with reports in clinical use.
CONCLUSIONS
In an open-label trial involving adults with mild asthma, budesonide–formoterol used as needed was superior to albuterol used as needed for the prevention of asthma exacerbations.
The New England Journal of Medicine
Controlled Trial of Budesonide–Formoterol as Needed for Mild Asthma | NEJM
In double-blind, placebo-controlled trials, budesonide–formoterol used on an as-needed
basis resulted in a lower risk of severe exacerbation of asthma than as-needed use
of a short-acting β2-agonis...
basis resulted in a lower risk of severe exacerbation of asthma than as-needed use
of a short-acting β2-agonis...