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Free Content Randomized dose-ranging study of a budesonide metered-dose inhaler by using co-suspension delivery technology in asthma

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Background:

This is the first study of the inhaled corticosteroid, budesonide, delivered by metered-dose inhaler (BD MDI) using innovative co-suspension delivery technology in adults with asthma.

Objective:

To characterize the effects of BD delivered by MDI on lung function and safety.

Methods:

Randomized, double-blind, 4-week cross-over, placebo-controlled, phase IIb study of adults (18‐65 years of age) with mild-to-moderate persistent asthma. The subjects received twice-daily BD MDI 320 μg, 160 μg, and placebo MDI, and either BD MDI 80 μg or 40 μg. The primary endpoint was change from baseline in morning trough forced expiratory volume in 1 second (FEV1) at the end of the treatment period (EOT). Secondary endpoints included change from baseline in morning and evening predose peak expiratory flow rate (PEFR), rescue medication use, and Asthma Control Questionnaire 5-question version (ACQ-5) score. Safety was also assessed.

Results:

A total of 147 subjects were randomized. All doses of BD MDI improved morning trough FEV1 at EOT, and morning and evening predose PEFR in the last treatment week versus placebo (all p < 0.01), with improvements in trough FEV1 exceeding 100 mL for BD MDI 320 μg, and 160 μg only. Compared with placebo, all BD MDI doses reduced rescue medication use in the last week of treatment (p < 0.01) and improved ACQ-5 scores at EOT (all p < 0.01). All treatments were well tolerated.

Conclusion:

Analysis of the data demonstrated greater efficacy improvements for the higher doses of BD MDI (320 μg and 160 μg), with similar adverse event profiles compared with the lower doses. Hence, BD MDI 320 μg and 160 μg warrant further evaluation in subjects with persistent asthma.

Clinical trial NCT02105012, www.clinicaltrials.gov
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Keywords: asthma; budesonide; clinical trial; co-suspension delivery technology; forced expiratory volume; inhaled corticosteroid; metered-dose inhaler; monotherapy; peak expiratory flow rate; phase IIb

Document Type: Research Article

Affiliations: 1: From the Northeast Medical Research Associates, Inc., North Dartmouth, Massachusetts 2: Pearl - a member of the AstraZeneca Group, Morristown, New Jersey 3: AstraZeneca, Gaithersburg, Maryl

Publication date: 01 September 2018

This article was made available online on 23 July 2018 as a Fast Track article with title: "Randomized dose-ranging study of a budesonide metered-dose inhaler by using co-suspension delivery technology in asthma ".

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  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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