Inhaled corticosteroids (ICSs) are recommended
as first-line therapy for
patients with persistent asthma and as
adjunctive therapy in patients with
chronic obstructive pulmonary disease
(COPD) who experience exacerbations.
Administration of nebulized budesonide
inhalation suspension (BIS) may be an
appropriate alternative in certain
patients with asthma or COPD that are
uncontrolled with ICS delivery via dry
powder inhaler (DPI) or pressurized
metered-dose inhaler (MDI). In the
U.S.A., BIS is approved for children
aged 12 months to 8 years with asthma.
In many other countries BIS also is
approved for use in adults. In this case
series, 12 patients with poorly controlled
asthma aged 31 - 72 years and 13
patients with poorly controlled COPD
aged 54 - 84 years were initiated on ICS
therapy with nebulized BIS or transitioned
from their usual ICS treatment to
nebulized BIS and observed for ! 1
year. Changes in the number of exacerbations
requiring oral corticosteroids
and forced expiratory volume in 1 second
(FEV1) from the previous year
(during which patients received their
usual asthma or COPD therapy) to the
following year (during which patients
received nebulized BIS) were assessed.
The number of exacerbations requiring
oral corticosteroids decreased by an
average of 3.6 exacerbations in patients
with asthma and by an average of 2.5
exacerbations in patients with COPD
during BIS treatment compared with the
previous year. Clinical improvements in
FEV1 occurred in 58% of these patients
with long-standing disease. Reported
improvements in asthma control and
pulmonary function suggest that BIS