This paper is only available as a PDF. To read, Please Download here.
Abstract
The main objective of this study was to show dose-dependent equivalence in the systemic activity of budesonide 800 μ g day−1and 1600 μ g day−1delivered from either Easyhaler®or Turbuhaler®in healthy male subjects.
This single-centre study was carried out according to a randomized, double-blind, double-dummy, five-way cross-over design over a 9-week period. All subjects received 1 week of treatment with the following, in randomized order, with a washout week between each treatment: budesonide Easyhaler®800 μ g day−1plus placebo Turbuhaler®; budesonide Easyhaler®1600 μ g day−1plus placebo Turbuhaler®; placebo Easyhaler®plus Pulmicort®Turbuhaler®800 μ g day−1; placebo Easyhaler®plus Pulmicort®Turbuhaler®1600 μ g day−1; placebo Easyhaler®plus placebo Turbuhaler®. The final inhalation of study drug was performed at the study centre, where blood and urine samples were collected.
Fifteen subjects were recruited and all completed the study. Mean serum cortisol AUC0–20values (the primary outcome variable) were comparable for each device at the two dose levels, and met the defined criteria for equivalence (90% CI 0·8–1·25 for between-treatment difference). Budesonide 800 μ g day−1caused minimal suppression of serum cortisol AUC0-20values. Budesonide 1600 μ g day−1statistically significantly suppressed serum cortisol AUC0–20values compared with placebo. Mean morning serum cortisol values were within the reference range in all treatment groups. At a budesonide dose of 800 μ g day−1mean urine cortisol/creatinine ratio was statistically significantly higher with Easyhaler®than with Turbuhaler®, but there was no significant difference between the devices at the 1600 μ g day−1dose. Serum budesonide concentrations were equivalent for each device at both dose levels. Adverse drug reactions were infrequent and mild in nature and there were no clinically significant changes in laboratory safety variables.
In conclusion, in healthy male volunteers, budesonide 800μ g day−1and 1600 μ g day−1inhaled from Easyhaler®had comparable systemic effects to the same doses inhaled via Turbuhaler®.
Keywords
References
REFERENCES
- Comparison of inhaled corticosteroids.Ann Pharmacother. 1998; 32: 220-232
- Pharmacokinetics and metabolism of budesonide, a selective glucocorticoid.Eur J Respir Dis. 1982; 63: 86-95
- The influence of orally deposited budesonide on the systemic availability of budesonide after inhalation from a Turbuhaler®.Br J Clin Pharmacol. 1993; 36: 211-214
- Lung deposition of budesonide from pressurized metered-dose inhaler attached to a spacer.Eur Respir J. 1998; 12: 1340-1345
- Assessment of the relative systemic potency of inhaled fluticasone and budesonide.Eur Respir J. 1996; 9: 1427-1432
- Systemic effects of inhaled corticosteroids in asthma: a comparative risk-profile assessment of fluticasone propionate and budesonide.Inpharma. 1996; : 1-11
- Measures for detecting systemic bioactivity with inhaled and intranasal corticosteroids.Thorax. 1997; 52: 476-482
- Delivery devices for inhaled asthma medication. Clinical implications of differences in effectiveness.Clin Immunother. 1996; 6: 273-299
European Commission, Communication from the Commission to the Council and the European Parliament: Strategy for the phaseout of CFCs in metered-dose inhalers
- Improvement of pressurised aerosol deposition with Nebuhaler spacer device.Thorax. 1984; 39: 935-941
- Inhalation therapy problems and prospects.Eur Respir J. 1990; 3: 830-832
- Budesonide delivered by Turbuhaler is effective in a dose-dependent fashion when used in the treatment of adult patients with chronic asthma.J Allergy Clin Immunol. 1998; 101: 457-463
- Efficacy of once- and twice-daily administration of budesonide via Turbuhaler as initial therapy in patients with mild persistent asthma.Respir Med. 1999; 93: 230-235
- Rapid onset of control with budesonide Turbuhaler in patients with mild- to-moderate asthma.Ann Allergy Asthma Immunol. 1999; 82: 463-471
- Effect of 1 year daily treatment with 400 microg budesonide (Pulmicort Turbuhaler) in newly diagnosed asthmatics.Eur Respir J. 1997; 10: 2210-2215
- A novel multiple dose powder inhaler. Salbutamol powder and aerosol give equal bronchodilatation with equal doses.Ann Allergy. 1994; 72: 178-182
- Equivalence of two steroid-containing inhalers: Easyhaler multidose powder inhaler compared with conventional aerosol with large-volume spacer.Respiration. 2000; 67: 194-202
- Determination of urinary free cortisol by HPLC.Clin Chem. 1997; 43: 1386-1391
- JAMA. 1997; 277: 925-926
- Assessment of the systemic effects of beclomethasone dipropionate (BDP) inhaled via Easyhaler®or via Diskhaler®in healthy male volunteers.Eur J Clin Pharmacol. 2000; 56: 625-629
- Comparative assessment of safety and efficacy of inhaled corticosteroids: report of a committee of the Canadian Thoracic Society.Eur Respir J. 1998; 11: 1194-1210
- Adrenal suppression with chronic dosing of fluticasone propionate compared with budesonide in adult asthmatic patients.Thorax. 1997; 52: 55-58
- A five-way parallel randomized study to compare the safety profile of beclomethasone dipropionate, budesonide, flunisolide, fluticasone propionate, and triamcinolone acetonide (abstract).Chest. 1996; 110: 83s
- A dose-response study comparing suppression of plasma cortisol induced by fluticasone propionate from Diskhaler and budesonide from Turbuhaler.Eur J Clin Pharmacol. 1997; 52: 261-267
- An assessment of the systemic effects of single and repeated doses of inhaled fluticasone propionate and inhaled budesonide in healthy volunteers.Eur J Clin Pharmacol. 1996; 49: 459-463
- An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers.Br J Clin Pharmacol. 1994; 38: 521-525
- Lung deposition of budesonide from Turbuhaler®is twice that from a pressurized metered-dose inhaler p-MDI.Eur Respir J. 1994; 7: 1839-1844
Article info
Publication history
Accepted:
June 11,
2001
Received:
March 6,
2001
Identification
Copyright
© 2001 Harcourt Publishers Ltd. Published by Elsevier Inc.
User license
Elsevier user license | How you can reuse
Elsevier's open access license policy

Elsevier user license
Permitted
For non-commercial purposes:
- Read, print & download
- Text & data mine
- Translate the article
Not Permitted
- Reuse portions or extracts from the article in other works
- Redistribute or republish the final article
- Sell or re-use for commercial purposes
Elsevier's open access license policy