Source: DGNews  |  Posted 9 years ago

By Roberta Friedman
Special to DG News

SAN ANTONIO, TX -- November 15, 2002 -- Early use of inhaled steroids staves off the decline in respiratory function seen with asthma, suggest findings from a multinational trial presented at a symposium here today.

Starting inhaled steroids early also avoids hospital stays for exacerbations of mild, persistent asthma, researchers with the Steroid Treatment as Regular Therapy (START) trial reported at the meeting of the American College of Allergy, Asthma & Immunology.

Budesonide lowered the hazard rate of severe exacerbations of asthma by 44 percent, researchers reported.

The START study tested the "real life" use of budesonide around the world. It recruited more than 7000 patients in 32 countries. Doctors were allowed to use any therapy they judged necessary, as well as the study drugs, to keep asthma under control. The trial randomized patients to inhaled budesonide or placebo.

The power of the large trial allowed the investigators to find statistically significant differences between the two groups. Forced expiratory volume in one second (FEV1) before bronchodilator use, was reduced less in the budesonide group. As a percent of predicted value, FEV1 declined with budesonide use by 0.62 percent and by 1.79 percent at year one and three of the trial, compared to 2.11 percent and 2.68 percent respectively for the group assigned to placebo.

Teens did not show the improvement, but also did not show the decline in FEV1. "This is a new finding," said study investigator Soren Pedersen, MD, PhD. "We don