To Compare the Efficacy of Oral Deflazacort, Oral Prednisolone and Inhaled Budesonide in the Treatment of Salbutamol Refractory Acute Asthma in Children

Authors

Santosh Kondekar, TNMC and BYL Nair Hospital MumbaiFollow
Unmesh Dev M, TNMC and BYL Nair Hospital, MumbaiFollow
Surbhi Rathi, TNMC and BYL Nair Hospital MumbaiFollow
Gulrej N. Shaikh, TNMC and BYL Nair Hospital, MumbaiFollow

Author ORCID Identifier

https://orcid.org/0000-0002-6037-2215

Corresponding Author

Dr. Unmesh Dev M

unudev@gmail.com

Abstract

Abstract

Background: A 22-month open-label randomized comparative study was conducted at tertiary care centre attached to medical college in metropolitan city in Maharashtra from Dec 2011 to Oct 2013, aiming to compare the effectiveness of three corticosteroid treatments - oral deflazacort, oral prednisolone, and inhaled budesonide in managing salbutamol-refractory asthma in children aged 1-14 years.

Methods: 90 afebrile children were equally allocated to the different treatment arms. Treatment arm A received oral Deflazacort (1mg/kg/day alternate day), treatment arm B received oral prednisolone (1mg/kg/day), and treatment arm C received budesonide inhaler (100 mcg/puff twice a day) for seven days, along with salbutamol inhalations twice a day. The primary outcome measured was the change in FEV1 and PEFR as a percentage of the predicted value from baseline, and secondary outcomes included changes in FVC, wheeze frequency, VCD, and FEV1/FVC.

Results: Wheeze varied across treatment arms on day 3 (A: 16.3%, B: 26.7%, C: 70.0%), day 7 (A: 10.0%, B: 0.0%, C: 10.0%), and day 28 (A: 16.7%, B: 0.0%, C: 16.7%). Mean PEFR values on days 1, 3, 7, and 28 were 140.67, 180, 202.67, 216.67 for Treatment Arm A; 141.43, 190, 203, 221 for Treatment Arm B; and 151.00, 179.33, 187.33, 202.00 for Treatment Arm C, respectively. FEV1 and FEV1/FVC scores showed no significant differences across the three treatment arms.

Conclusion: In treating salbutamol-refractory asthma in children, all three medications displayed comparable efficacy, aiding clinicians in treatment selection and improving outcomes. Future research should prioritize long-term effects and safety for optimal management.

Publication Date

2024

Publisher

JSS Academy of Higher Education & Research

Conflict of Interest

none

Keywords

Asthma, Deflazacort, Prednisolone, Budesonide, Salbutamol

Word Count

2600

Recommended Citation

Kondekar S, M UD, Rathi S, Shaikh GN. To Compare the Efficacy of Oral Deflazacort, Oral Prednisolone and Inhaled Budesonide in the Treatment of Salbutamol Refractory Acute Asthma in Children. Digital Journal of Clinical Medicine. 2024; 6(2): -. doi: https://doi.org/10.55691/2582-3868.1174

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