Inhaled budesonide to prevent BPD

A multicenter randomized trial from Europe in infants 23 – 27 weeks tested the efficacy of inhaled budesonide compared to placebo. The medication was initiated within 24 hours of birth and continued until 32 weeks post-menstrual age or until discontinuation of positive pressure support with supplemental oxygen. There was no statistical difference in the primary composite outcome of death or BPD between the two groups. There was a statistically lower incidence of survival with BPD in the budesonide group (28 vs 38%), but also an absolute increase in death by 3% that was not statistically significant, raising concern that the benefit on BPD may have been gained at the expense of increased mortality.

Early inhaled budesonide for the prevention of bronchopulmonary dysplasia. Bassler et al, 2015.