Early Inhaled Budesonide for Bronchopulmonary Dysplasia: A Note of Caution

Administering steroids beginning in the first 24 hours of life may increase mortality in extremely preterm infants.

Bronchopulmonary dysplasia is the most frequent morbidity of extreme prematurity. In a recent industry-funded trial (JW Pediatr Adolesc Med Nov 2015 and N Engl J Med 2015; 373:1497), early treatment with inhaled budesonide significantly lowered the risk for bronchopulmonary dysplasia compared with placebo, but a trend towards higher mortality was also observed. Now, in a planned follow-up of that trial's enrolled infants, investigators assessed neurodevelopmental disability at a corrected age of 18 to 22 months.

In the original study, 863 extremely preterm babies (gestational age, 23–27 weeks) were randomized in the first 24 hours of life to receive early inhaled budesonide or placebo. Budesonide was delivered as two puffs (200 μg per puff) …

Reviewing Author

Robin Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Robin Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Early Inhaled Budesonide for Bronchopulmonary Dysplasia: A Note of Caution

Topics

Reviewing Author