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Early inhaled budesonide in extremely preterm infants decreases long‐term respiratory morbidity
Author(s) -
Tukova Jana,
Smisek Jan,
Zlatohlavkova Blanka,
Plavka Richard,
Markova Daniela
Publication year - 2020
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24704
Subject(s) - medicine , bronchopulmonary dysplasia , budesonide , spirometry , vital capacity , cohort , obstructive lung disease , pulmonary function testing , pediatrics , respiratory disease , asthma , lung , lung function , diffusing capacity , copd , pregnancy , gestational age , genetics , biology
Abstract Background There is no strict correlation between early bronchopulmonary dysplasia and long‐term respiratory disease. Early inhaled corticosteroids seem to reduce the incidence of bronchopulmonary dysplasia, but the long‐term outcome remains unknown. Research Question The aim of this study was to evaluate the effect of early inhaled corticosteroids on chronic respiratory morbidity. Methods Fifty‐nine survivors from the Prague cohort included in Neonatal European Study of Inhaled Steroids underwent further follow‐up comprising of respiratory morbidity monitoring during the first 2 years of life followed by objective lung function testing performed at the age of 5.9 years (range 5‐7 years). Both outcomes were pursued and finalized before the unblinding of budesonide subgroups. Results Fifty randomized (budesonide vs placebo group, 56% vs 44%) survivors were included in the study. Spirometry was successfully performed in 48 children. No statistically significant differences were found in the lung function test (forced expiratory flow [FEF] ‐ FEF 75 , FEF 50, FEF 25 , and FEF 25‐75; FEV 1 , forced vital capacity [FVC], FEV 1 /FVC) although mild trend to the improvement of expiratory flow pattern was observed in the budesonide group (median z ‐score of FEV 1 /FVC −0.376 vs −0.983, P = .13; median z ‐score of FEF 25‐75 −1.004 vs −1.458, P = .13; median z ‐score of FEF 75 −0.527 vs −0.996, P = .17). Children assigned to budesonide had a significantly lower rate of symptoms of chronic lung disease (34.6% vs 68.2%; P = .04) than children assigned to placebo. Interpretation Our study suggests that early inhaled budesonide was associated with the trend to the improvement of functional lung parameters and with a lower rate of symptoms of chronic lung disease within the first 2 years of life.