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Copyright ©ERS Journals Ltd 2004
Dose-response relationship of inhaled budesonide in adult asthma: a meta-analysis
1 Medical Research Institute of New Zealand, 2 P3 Research, and 3 Wellington School of Medicine & Health Sciences, Wellington, New Zealand. 4 University of Southampton, Southampton, UK
CORRESPONDENCE: R. Beasley, Medical Research Institute of New Zealand, PO Box 10055, Wellington, New Zealand. Fax: 64 44729224. E-mail: richard.beasley@mrinz.ac.nz
Keywords: Adults, asthma, budesonide, dose-response, inhaled corticosteroids, meta-analysis
Received: July 3, 2003
Accepted December 15, 2003
The aim of this study was to examine the dose-response relationship of inhaled budesonide in adolescents and adults with asthma.
A meta-analysis was carried out on placebo-controlled, randomised clinical trials, presenting data on at least one outcome measure of asthma and using at least two doses of budesonide, delivered by turbuhaler or metered-dose inhaler+spacer twice daily.
A total of six studies of 1,435 adolescents and adults, with mild to moderately severe asthma, met the inclusion criteria for the meta-analysis. A negative exponential model indicated that 80% of the benefit at 1,600 µg·day–1 was achieved at doses of
In conclusion, the available published data indicate that, in adolescents and adults with mild to moderate asthma, most of the therapeutic benefit of budesonide delivered by turbuhaler or metered-dose inhaler+spacer is achieved with a dose of
200–400 µg·day–1 and 90% by 300–600 µg·day–1. Meta-regression with a quadratic term in dose showed that the maximum effect was obtained with doses of 1,000 µg·day–1. 400 µg·day–1 and the maximum effect is achieved at 1,000 µg·day–1. This conclusion is qualified by the recognition that there is considerable individual variability in the response to inhaled corticosteroids and that the subjects included in this meta-analysis had predominantly mild to moderate asthma.
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