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Study of Budesonide as an Addition to Standard Therapy in Adult Asthmatics in the Emergency Room.

Registration Number
NCT00588406
Lead Sponsor
Northwell Health
Brief Summary

To determine whether adding nebulized inhaled steroids to the standard care of acutely ill ED patients with refractory acute asthma helps improve forced expiratory volume at one second (FEV1) and decrease the need for hospitalization.

Detailed Description

This is a randomized clinical trial studying the effect of nebulized budesonide (Pulmicort) in acutely ill adults presenting to the Emergency Department with severe asthma. Budesonide is an inhaled steroid FDA approved for the treatment of pediatric chronic asthma. ED entry criteria include hyporesponsiveness to nebulized beta-agonists and an FEV1\<50% predicted. The trial will evaluate the efficacy of multiple doses of nebulized budesonide as an adjunct to a highly regimented standardized treatment protocol; standard care consists of bronchodilators (beta-agonists/anticholinergics), systemic steroids, and intravenous magnesium sulfate (if the FEV1\<25% predicted). The primary efficacy endpoint will be the FEV1 4 hours after administration of the study intervention. An additional safety and efficacy endpoint will take place at 5 hours after study intervention. The treatments will be coupled with a protocol-defined assessment regimen, with endpoints measured before each treatment and on ED disposition (at 5 hours after study intervention).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
95
Inclusion Criteria
  • FEV1<50% predicted after bronchodilator therapy, age 18-60, presenting to an emergency department with acute asthma
Exclusion Criteria
  • other chronic lung disease, >15 pack years smoking

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BBudesonideBudesonide, 2mg, 4 doses, plus standard care
BalbuterolBudesonide, 2mg, 4 doses, plus standard care
BIpratropium bromideBudesonide, 2mg, 4 doses, plus standard care
PIpratropium bromidePlacebo plus standard care
PPrednisonePlacebo plus standard care
PalbuterolPlacebo plus standard care
BPrednisoneBudesonide, 2mg, 4 doses, plus standard care
Primary Outcome Measures
NameTimeMethod
FEV1 Percent Predicted4 hours post-randomization
Secondary Outcome Measures
NameTimeMethod
Hospitalization6 hours

Trial Locations

Locations (3)

Nassau University Medical Center

🇺🇸

East Meadow, New York, United States

Long Island Jewish Medical Center

🇺🇸

Queens, New York, United States

Jacobi Medical Center

🇺🇸

Bronx, New York, United States

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