Inhaled mometasone and budesonide have the same efficacy, but mometasone 800 mcg affects the HPA axis

This study directly compared the effects of two inhaled glucocorticoids (ICS), mometasone and budesonide.

12 patients with documented early and late asthmatic responses (EAR and LAR) to inhaled allergen were randomized to a 7-day treatment with:

- mometasone (200 mcg x 2 or 400 mcg x 2)
- budesonide (400 mcg x 2)
- placebo

Mometasone and budesonide attenuated the asthmatic response to a similar degree. No effects on the lung function parameters were observed (previous studies have shown that it takes 2 weeks for ICS to exert an effect on PFTs).

However, at the dose of 800 mcg daily, mometasone reduced 24 h urinary cortisol by 35%.

Mometasone and budesonide are equieffective in reducing early and late asthmatic responses induced by inhaled allergen challenge. Mometasone 800 mcg given for 7 days partially affects the HPA axis.

Asthma Inhalers (click to enlarge the image):



References:

Comparing the effects of two inhaled glucocorticoids on allergen-induced bronchoconstriction and markers of systemic effects, a randomised cross-over double-blind study. Jan Lotvall, Mona Palmqvist and Peter Arvidsson. Clinical and Translational Allergy 2011, 1:12 doi:10.1186/2045-7022-1-12.