Examination of the antiinflammatory effects of using inhaled corticosteroids daily and every other day in children with asthma via nitric oxide level in inspired air and respiratory functions

Introduction and Aim: Asthma is a chronic inflammatory respiratory disease proceeding with dispnea, wheezing and cough. In this study, it was aimed to determine if use of inhaled corticosteroids every other day is effective or not in asthma.Patients and Methods: 60 patients between the ages of 6 and 18 with mild persistent asthma presented to our outpatient clinics between 2009 and 2010 were included in this study. Our patients were chosen from the ones who did not receive any drugs except for bronchodilatator during the last two months. Patients included in the study were examined before testing. Individuals with a history of lower or upper viral or bacterial infection in the last 4 weeks, active or passive smokers, individuals with other related pulmonary diseases including bronchiectasis, individuals with a history of acute asthma attack in the last 30 days, individuals with chronic disease and individuals who had to use oral corticosteroid during follow-up were not included in the study. Patients were divided into three groups randomly. 200 microgram inhaled budesonide daily was given to Group 1, 400 microgram inhaled budesonide was given every other day to Group 2 and salmeterol 2 x 50 mcg if needed was given for a period of 6 weeks to Group 3. Each patient was assessed at 0, 3 and 6th weeks. FEV1 and nitric oxide values were measured at each period.Findings: In this study, FEV1 values were increased significantly (p<0.001) and NO values were decreased significantly (p<0.001) in Group 1 and Group 2 where patients received inhaled budesonide daily and every other day. In statistical comparison of the groups receiving budesonide daily and every other day, no difference was found in FEV1 (p=0.94) and NO (p=0.58) values. Although no statistical difference was found in FEV1 (p=0.48) and NO (p=0.52) values between weeks in the group where patients received salmeterol if needed, no difference was found when compared to Group 1 and Group 2.Interpretation: Since NO levels in the inspired air are sensitive to corticosteroid treatment, measurement of NO in inspired air may be beneficial for monitoring the response to inhaled corticosteroids. The fact that response to treatment was found similar between patients who received inhaled corticosteroids daily and every other day suggests that inhaled corticosteroids can be used every other day.