Bronchoscopic biopsies of bronchial mucosa before and after beclomethasone dipropionate therapy.

Thiringer, G; Eriksson, N; Malmberg, R; Svedmyr, N; Zettergren, L

doi:10.1111/j.1365-2125.1977.tb04524.x

Cited by 10 publications

(9 citation statements)

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“…Our results support those from others (9,10,12): that there is no evidence of bronchial mucosai atrophy caused by inhaled steroids even when used in high doses. The reason for this could be that the doses of inhaled steroid are deposited over a large area in contrast to local application of steroids to the skin, and that lung fibroblasts might be less sensitive to steroids than skin fibroblasts (11).…”

Section: Discussionsupporting

confidence: 93%

“…Glueocorticoids cause atrophy when repeatedly applied to the skin (4) and this has caused considerable concern when eorticosteroids were introduced for long-term inhalation treatment of severe asthmatics. However, earlier studies have shown no evidence of epithelial damage to the airways even after 3 years of treatment with conventional doses of beclomethasone dipropionate (9,10,12).…”

mentioning

confidence: 96%

“…However, earlier studies have shown no evidence of epithelial damage to the airways even after 3 years of treatment with conventional doses of beclomethasone dipropionate (9,10,12). However, earlier studies have shown no evidence of epithelial damage to the airways even after 3 years of treatment with conventional doses of beclomethasone dipropionate (9,10,12).…”

mentioning

confidence: 99%

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Fiberoptic bronchoscopy and bronchial mucosal biopsies in asthmatics undergoing long‐term high‐dose budesonide aerosol treatment

Laursen

Taudorf

Borgeskov

et al. 1988

Allergy

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Mucosal biopsies from the pharynx, right main stem bronchus and right lower lobe were obtained during flexible fiberoptic bronchoscopy and were examined with light microscopy (LM) and electron microscopy (EM) in 10 asthmatics after 11 months' (range 7-15 months) treatment with high doses of inhaled budesonide via the Nebuhaler, i.e. 1600 micrograms daily. Results were compared with biopsies from 10 controls suspected of having focal, malignant lung diseases. Visual inspection of the tracheobronchial tree showed no signs of atrophy, ulcerations or thrush patches, and LM and EM showed no specific signs of mucosa and connective tissue atrophy; however, epithelial desquamation was seen in the asthmatics. No complications were observed.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 96%

mentioning

confidence: 99%

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Fiberoptic bronchoscopy and bronchial mucosal biopsies in asthmatics undergoing long‐term high‐dose budesonide aerosol treatment

Laursen

Taudorf

Borgeskov

et al. 1988

Allergy

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“…Not until daily doses of 0.8 mg beclomethasone are being given, can systemic side effects be demonstrated in the form of a poor depression of the adrenocortical function. The only local side effeet observed is oropharyngeal candidiasis (oral thrush) (22). The thrush is seldom seen with low dosage, but can beeome a problem with higher doses.…”

Section: Glucocorticoidsmentioning

confidence: 99%

The Pharmacological Basis of Drug Treatment in Bronchial Asthma

Norn

Skov

1980

Allergy

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“…This standard dose has been shown not to suppress the pituitary-adrenal axis.56 Furthermore, it does not affect linear growth7 and has no long term deleterious effect on the bronchial mucosa. 8 Problems with compliance are more frequent when drugs have to be taken several times a day.9 "'Treatment twice daily is easier to manage than treatment four times daily, especially in children as parental supervision can be more strict and it removes the inconvenience of having to take medication at school.…”

mentioning

confidence: 99%

Twice daily versus four times daily treatment with beclomethasone dipropionate in the control of mild childhood asthma.

Williams¹,

Jones²,

Sibert³

1986

Thorax

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The effects of controlling childhood asthma of the same daily dose (400 pg) of beclomethasone dipropionate, given in two or four equal divided doses from a metered aerosol, were compared in a double blind crossover study. Thirty one children aged 6-14 years completed the study. They had previously been shown to need beclomethasone by showing either symptoms or reduced peak flow when the treatment was withdrawn. They recorded their daytime and night time symptoms on a visual analogue scale and their morning and evening peak expiratory flow (PEF), and recorded their symptomatic use of bronchodilator aerosols. Spirometry was performed at the end of each treatment period. Control of asthma was good on both regimens. There were small differences in both objective and subjective measurements in favour of the four times daily regimen, but none reached statistical significance, apart from patients' assessment of daytime wheeze (p < 0-05). In particular, the differences in the results of lung function tests were very small. Compliance was better for morning and evening doses. These results suggest that beclomethasone given as 200pg twice daily is effective in controlling mild childhood asthma. It may be preferable to lOO1g four times daily because of better compliance and because it is unnecessary to take medication to school.Inhaled beclomethasone dipropionate has been used for over 10 years in the treatment of childhood asthma.' 2 During that time many accounts of its usefulness and safety have been published.34 The recommended standard dose of 100 pg (two puffs from a metered dose inhaler) four times a day has been shown to be effective in controlling symptoms and it can successfully replace oral steroid treatment in a large proportion of steroid dependent patients. This standard dose has been shown not to suppress the pituitary-adrenal axis.56 Furthermore, it does not affect linear growth7 and has no long term deleterious effect on the bronchial mucosa.8Problems with compliance are more frequent when drugs have to be taken several times a day.9 "'Treatment twice daily is easier to manage than treatment four times daily, especially in children as parental supervision can be more strict and it removes the inconvenience of having to take medication at school.

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Bronchoscopic biopsies of bronchial mucosa before and after beclomethasone dipropionate therapy.

Cited by 10 publications

References 1 publication

Fiberoptic bronchoscopy and bronchial mucosal biopsies in asthmatics undergoing long‐term high‐dose budesonide aerosol treatment

Fiberoptic bronchoscopy and bronchial mucosal biopsies in asthmatics undergoing long‐term high‐dose budesonide aerosol treatment

The Pharmacological Basis of Drug Treatment in Bronchial Asthma

Twice daily versus four times daily treatment with beclomethasone dipropionate in the control of mild childhood asthma.

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