LAUSR

In the present issue of the European Respiratory Journal, Berger et al. [1] report the lack of efficacy of inhaled budesonide for the prevention of acute mountain sickness (AMS). This small well-designed study was undertaken to verify or refute the provocative finding of robust protection with budesonide against AMS reported by Chinese colleagues in 2014 [2] and 2015 [3]. In the presently reported study, 50 healthy volunteers were randomly assigned to inhale twice daily budesonide 200 μg, budesonide 800 μg or a placebo 1 day prior and during climbing in less than 48 h to an altitude of 4559 m. Such a rapid active ascent is known to be associated with a more than 50% incidence of AMS symptomatology [4]. Accordingly, AMS indeed occurred in 53% of the subjects in the placebo group, and in 56% and 76% of the subjects assigned to the 200 μg and 800 μg budesonide groups, respectively. Between group differences were not significant. Clearly, inhaled budesonide did not prevent acute mountain sickness. Inhaled corticosteroids are ineffective for the treatment of acute mountain sickness http://ow.ly/gz0i30eawqn