Effect of nebulized corticosteroids on long-term poorly controlled asthma in elderly patients

Abstract

Objective To evaluate the efficacy and safety of long-term nebulized corticosteroids and inhaled bronchodilators therapy on asthma in long-term poor controlled elderly patients. Methods Prospective, randomized control study was conducted. 63 elderly asthma patients, who received inhaled corticosteroids or combined with other long-term medication treatment for asthma control for more than 3 months but were still in moderate to severe persistent asthma state, were randomly divided into nebulizer treatment group (n=31) and dry powder inhalation group (n=32), and they were treated correspondingly with Budesonide inhalation suspension 1 mg and Salbutamol 2.5 mg BidorBudesonide/Formoterol powder 320/9 μg inhalation Bid. Patients in the two groups were evaluated for the differences in lung function, acute exacerbations of asthma, asthma control test (ACT) and adverse effects after 12-week treatment. Results The improvement in morning peak expiratory flow (PEF) and ACT score were better in the test group than in the control group 〔(29.2±14.4) ml vs. (15.8±13.5) ml, (4.8±2.2) vs. (3.0±2.7), t=3.715 and 2.897, P=0.000 and 0.005〕, but there were no statistical differences in average daily use of relievers and severe acute exacerbations between the test and control groups (t=-1.512, P=0.136; χ2=2.238, P=0.135). The local adverse effects caused by inhaled corticosteroids had no significant difference between the two groups. Conclusions Compared with the powder inhalation, the nebulizer inhalation administration of corticosteroids and bronchodilators could improve the asthma symptoms and lung function better in elderly patients with serious asthma condition and shows a good safety in the 12 weeks of continuous treatment. Key words: Asthma; Glucorticosteroids; Metered dose inhalers