A Delphi consensus on nebulized budesonide for adults with asthma and COPD
9
Issued Date
2026-03-01
Resource Type
ISSN
0125877X
Scopus ID
2-s2.0-105036101037
Pubmed ID
40459870
Journal Title
Asian Pacific Journal of Allergy and Immunology
Volume
44
Issue
1
Start Page
103
End Page
113
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asian Pacific Journal of Allergy and Immunology Vol.44 No.1 (2026) , 103-113
Suggested Citation
Wongsurakiat P., Rattanawongpaibul A., Limsukon A., Chiewchalermsri C., Maneechotesuwan K., Wiwatcharagoses K., Kornthatchapong K., Saiphoklang N., Sanguanwit P., Domthong P., Sewatanon T., Reechaipichitkul W., Kawamatawong T. A Delphi consensus on nebulized budesonide for adults with asthma and COPD. Asian Pacific Journal of Allergy and Immunology Vol.44 No.1 (2026) , 103-113. 113. doi:10.12932/AP-190824-1910 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116344
Title
A Delphi consensus on nebulized budesonide for adults with asthma and COPD
Author's Affiliation
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Ramathibodi Hospital
Faculty of Medicine, Khon Kaen University
Srinakharinwirot University
Rangsit University
Faculty of Medicine, Thammasat University
Thammasat University Hospital
Khon Kaen Regional Hospital
Maharaj Nakhon Ratchasima Hospital
Udonthani Hospital
Faculty of Medicine, Chiang Mai University
Ramathibodi Hospital
Faculty of Medicine, Khon Kaen University
Srinakharinwirot University
Rangsit University
Faculty of Medicine, Thammasat University
Thammasat University Hospital
Khon Kaen Regional Hospital
Maharaj Nakhon Ratchasima Hospital
Udonthani Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
BACKGROUND: Inhaled corticosteroids (ICS) represent an alternative treatment option to systemic corticosteroids (SCS) in the treatment of asthma and chronic obstructive pulmonary disease (COPD); however, detailed clinical guidance on the use of nebulized ICS, such as budesonide, in the management of asthma and COPD remains scarce. OBJECTIVE: To review the literature and develop Delphi consensus statements on the use of nebulized ICS for the management of asthma and COPD in adults. METHODS: An expert panel of 13 respiratory physicians, comprising pulmonologists (n = 9), allergists (n = 1), and emergency department consultants (n = 3) from tertiary medical centers in Thailand, undertook a Delphi procedure with the aim of developing evidence-based consensus statements on the use of nebulized ICS in patients with asthma and COPD. Panelists used a 5-point Likert scale to score their agreement with each statement. RESULTS: A total of 12 Delphi consensus statements pertaining to the use of nebulized ICS in the management of asthma and COPD in both acute and maintenance care were developed. The overall consensus of the panel across the 12 statements was very high (mean agreement score, 4.2-4.9/5). The panelists expressed strongest consensus agreement (84.6% strong agreement) with the following two statements: 1) inhalation devices are the cornerstone of drug delivery in patients with asthma and COPD, and 2) for adult asthma and COPD patients with severe exacerbations, nebulization is more suitable for drug delivery than a pMDI plus spacer. CONCLUSIONS: Nebulized budesonide is an effective and well tolerated treatment option for the management of asthma and COPD.