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Children with mild asthma: do they benefit from inhaled corticosteroids?

¹ Dept of Paediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, ² Dept of Paediatrics, Isala Klinieken, Zwolle, ³ Dept of Paediatrics, Catharina Hospital, Eindhoven, ⁴ Dept of Epidemiology and Biostatistics, Erasmus University Rotterdam, Rotterdam, and ⁵ Glaxo Wellcome, Zeist, the Netherlands

CORRESPONDENCE: H.G.M. Arets, Dept of Paediatric Pulmonology, University Medical Centre Utrecht, KG 01.319.0, PO box 85090, 3508, AB Utrecht, The Netherlands. Fax: 31 302504747. E-mail: h.arets@wkz.azu.nl

Keywords: children, inhaled corticosteroids, mild asthma, pulmonary function

Received: November 6, 2001
Accepted June 9, 2002

This study was sponsored by Glaxo Wellcome, Zeist, the Netherlands.

In children with mild asthma, who show hardly any abnormalities in pulmonary function, objective measurement of the effect of inhaled corticosteroids is difficult.

The short term effect of fluticasone propionate (FP) in these children was evaluated, using both subjective and objective parameters. A total of 68 children (5–10 yrs old) were randomly assigned to either FP 250 µg or placebo twice daily as metered-dose inhaler via spacer during 12 weeks. Symptom scores, use of rescue medication, wheezing, parent global evaluation and pulmonary function tests including forced expiratory volume in one second (FEV₁), peak expiratory flow (PEF) and bronchial responsiveness (provocation dose of methacholine causing a 20% fall in FEV₁ (PD₂₀)) were evaluated.

FP-treated versus placebo-treated children showed significant changes in percentage symptom-free days, use of ß₂-mimetics, morning and evening PEF, FEV₁ % pred and wheezing. No significant improvements were found in parent global evaluation, absolute values of FEV₁ nor PD₂₀.

These findings show that inhaled corticosteroids are effective in children with mild asthma. This effect can be assessed by both objective and subjective parameters. Early start of inhaled corticosteroids should be considered even when pulmonary function is normal.

This article has been cited by other articles:

				M. L. Garcia Garcia, U. Wahn, L. Gilles, A. Swern, C. A. Tozzi, and P. Polos Montelukast, Compared With Fluticasone, for Control of Asthma Among 6- to 14-Year-Old Patients With Mild Asthma: The MOSAIC Study Pediatrics, August 1, 2005; 116(2): 360 - 369. [Abstract] [Full Text] [PDF]