Cortisone Spray containing Budesonide

According to a study from Oxford University, early treatment with the asthma drug budesonide can reduce the risk of severe COVID-19 in SARS-CoV-2 infection and shorten the time to recovery.

Anti-inflammatory cortisone sprays (inhaled glucocorticoids) containing budesonide have long been used in clinical practice to treat bronchial asthma. Over the course of the coronavirus pandemic, evaluations consistently showed that people hospitalized with COVID-19 were significantly less likely to have chronic respiratory disease. The British research team therefore investigated in their study whether this could be due to the widespread use of cortisone sprays. And they also explored the question of whether commercially available asthma sprays might be an effective treatment for early COVID-19 disease.

The study was conducted as a phase 2, open-label, randomized-controlled trial. 146 subjects participated. All had had mild COVID-19 symptoms such as onset of cough and fever and/or olfactory disturbances for a maximum of seven days due to SARS-CoV-2 infection. They were randomly assigned to two equal treatment groups. One group received standard care as usual, and the other was asked to use the budesonide spray twice daily until their symptoms resolved.

Faster recovery and less severe courses of disease

It was then analyzed how many of the participants had to be hospitalized due to COVID-19 disease. In the standard group, this was the case for ten people, in the budesonide group for only one. And the asthma spray also had a positive effect on other factors: On average, people with budesonide treatment recovered one day earlier than the group with standard treatment. In addition, they had fever less frequently and also had to be treated less often with antipyretic medication (27 versus 50 percent). Participants in the budesonide group were also less likely to report persistent symptoms on days 14 and 28 of the observation period.

Further studies must follow to confirm results

The fact that the study was not placebo-controlled limits the power of the results. Nevertheless, the authors conclude that inhaled budesonide could be a simple, safe, well-studied, and cost-effective way to treat COVID-19 early and prevent severe courses. Since the drug is already used as an asthma inhaler, it is also readily available. The results should therefore be urgently tested in further studies.

Source: Ramakrishnan, S. et al.: Inhaled budesonide in the treatment of early COVID-19 (STOIC): a phase 2, open-label, randomised controlled trial. In: the Lancet Respiratory Medicine, inline publiziert am 09. April 2021