pulmicort and Substance-Related-Disorders

Budesonide, a corticosteroid with high topical anti-inflammatory activity and low systemic activity, has been shown to prolong time to relapse in Crohn's disease. In the present study, the efficacy of budesonide in an oral pH-modified-release formulation was evaluated for maintenance treatment in patients with steroid-dependent ulcerative colitis.. Fourteen patients with steroid-dependent ulcerative colitis in the reduction phase of conventional glucocorticosteroids (c-GCS) following a severe attack, were treated with budesonide 3 mg t.d.s. for 6 months. The primary investigation parameters were changes in the clinical activity index (CAI) and in the daily dose of c-GCS.. In 11 cases the CAI improved significantly and treatment with c-GCS could be terminated. Three patients experienced relapse and needed further c-GCS treatment. The average daily dose of c-GCS and the average value of the CAI before treatment with budesonide were significantly higher in the relapse group than in the remission group.. In patients with c-GCS-dependent ulcerative colitis, a dose of 9 mg budesonide daily in an oral pH-modified-release formulation was well tolerated, significantly decreased the CAI, and rendered c-GCS unnecessary in the majority of cases.

Topics: Administration, Oral; Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Budesonide; Chronic Disease; Colitis, Ulcerative; Female; Glucocorticoids; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Pilot Projects; Steroids; Substance-Related Disorders

Budesonide 400 micrograms daily, in nonsteroid-dependent asthma, can produce improvements in airway responsiveness and clinical asthma severity, with some patients returning to normal responsiveness and becoming asymptomatic. This study examined whether similar improvements occur when asthmatics, who are dependent upon inhaled steroids, take either a regular maintenance dose of inhaled steroid or twice that amount for a year. Thirty two asthmatics were each stabilized on the minimum amount of inhaled steroid that would keep symptoms non-troublesome. In a double-blind, randomized manner, half were assigned to remain on a maintenance dose (MD) and the rest received twice that dose (MDx2) for one year. Before and monthly throughout the study, airway responsiveness to methacholine was measured and clinical asthma severity assessed by questionnaire, inhaled bronchodilator use and number of asthma exacerbations. There was a significant improvement in airway responsiveness and clinical asthma severity in both treatment groups. Those on MDx2 showed the greatest improvement but the difference between the two groups did not reach significance. This study provides strong evidence that prolonged use of inhaled steroids is associated with improvement in airway responsiveness and clinical asthma severity in inhaled steroid-dependent asthma with a suggestion that the improvements are dose related.

Topics: Administration, Inhalation; Adult; Asthma; Beclomethasone; Bronchodilator Agents; Budesonide; Double-Blind Method; Drug Evaluation; Female; Forced Expiratory Volume; Humans; Lung; Male; Methacholine Chloride; Middle Aged; Pregnenediones; Substance-Related Disorders; Time Factors

Topics: Adolescent; Adult; Aerosols; Aged; Asthma; Budesonide; Female; Humans; Male; Middle Aged; Prednisone; Pregnenediones; Respiratory Therapy; Substance-Related Disorders