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Budesonide is a glucocorticoid with potent local anti-inflammatory effects. Budesonide can enhance the stability of endothelial cells, smooth muscle cells and lysosomal membranes, inhibit immune responses and reduce antibody synthesis, thereby reducing the release and activity of allergic active mediators such as histamine. It can also reduce the enzymatic process triggered when antigens and antibodies are combined, inhibit the synthesis and release of bronchoconstrictive substances and reduce the contractile response of smooth muscles. Acute, subacute and long-term toxicity studies have found that the systemic effects of budesonide, such as weight loss, lymphoid tissue and adrenal cortex atrophy, are weaker than or equivalent to other glucocorticoids.

Is budesonide effective in treating asthma?

Clinical Trials The MIST trial enrolled children with modified API positivity, recurrent wheezing, and ≥1 exacerbation in the past year but with low severity (defined as infrequent albuterol use and infrequent nocturnal awakenings between exacerbations). All subjects first received pretreatment with nightly placebo doses of budesonide inhalation suspension for 2 weeks (run-in period) and albuterol if necessary, and then received 52 weeks (treatment period) of randomized treatment. The intermittent treatment group (n=139) received 1 mg budesonide inhalation suspension twice a day for 7 days after the respiratory disease was diagnosed; the patients in the daily treatment group (n=139) received 0.5 mg budesonide inhalation suspension every night. Each group was also given a corresponding placebo dose of the drug.

The trial results showed that the incidence rates of asthma exacerbation in the budesonide treatment group and the intermittent treatment group were 0.97/(patient·year) and 0.95/(patient·year) respectively, and the relative incidence rate in the intermittent treatment group was 0.99. The incidence rates of non-serious adverse events and serious adverse events were also similar between the two groups, but the average cumulative exposure of budesonide in the intermittent treatment group was significantly smaller than that in the daily treatment group (45.7 mg vs 149.9 mg).