Effects of 4-week treatment with low-dose budesonide (100 ?g BID) from a novel inhaler Airmax™ and from a conventional inhaler on bronchial hyper-responsiveness, lung function and symptoms in patients with mild asthma

This study investigated the effect of low dose of budesonide 100 ?g b.d from a new multi-dose dry powder inhaler (Airmax™) and from a conventional inhaler (Turbuhaler®) on bronchial hyper-responsiveness, lung function and asthma symptoms in mild stable asthmatics. Twenty-five patients were enrolled into a double-blind double-dummy crossover study with two 4-week treatment periods separated by a 4-week washout. Patients had a mean forced expiratory volume in 1 s (FEV?) of 91±13% predicted, had previously received inhaled short-acting ??-agonists only and had a PC?? to adenosine 5? monophosphate (AMP)<40 mg/ml. PC?? AMP was assessed at baseline, and at the start and end of each treatment period. Patients recorded peak expiratory flow and symptoms throughout the study. There was a mean increase in PC??AMP from start to end of 3.49 doubling dilutions (DD) in the Airmax™ group and 2.90 DD in the Turbuhaler® group. The difference was 0.60 DD(95% CI—0.47, 1.69) favouring Airmax™ and the upper limit exceeded the equivalence limit of ±1 DD. There were similar improvements in FEV?, daily PEF and symptoms in both groups. The majority of patients preferred treatment with Airmax™ to Turbuhaler® (64 vs. 23%). Both treatments were equally well tolerated. In conclusion, 100 ?g budesonide bid during 4 weeks from AirmaxTM effectively attenuates the response to AMP in mild asthmatics. Overall Airmax™ offers equal clinical benefit to Turbuhaler® and is preferred by patients