TY - JOUR T1 - “Stepping down” in mild-to-moderate asthmatic children being well controlled while receiving low doses of inhaled corticosteroids (ICS): Daily vs. cyclical ICS administration (prospective, randomized, multicentre, open-label trial) JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P4300 AU - Sergey Tereshchenko AU - Snejana Bychkovskaya AU - Smirnov Nicolay Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P4300.abstract N2 - Existing guidelines postulate regular daily use of ICS in persistent asthma although in some cases various intermittent regimes may be useful.AIM: To compare the effects of daily with cyclical ICS administration on asthma control and exacerbations, lung function, and quality of life in stable mild-to-moderate asthmatic children.METHODS: Main inclusion criteria were as follows: (1) children aged 6-15 years, (2) mild or moderate persistent asthma, (3) previous low doses ICS treatment 3-12 months, (4) achieving full asthma control. After a 4-wk run-in on fluticasone propionate (FP) 250 mcg/day 70 patients from 4 Russian pulmonology clinics were randomized to daily or cyclical (administration 4 days/3 days break) FP 100 mcg/day treatment regimes for 12 weeks. Two-tailed exact Fisher test was used.RESULTS: There weren't significant differences between the treatment regimes in asthma control and exacerbations, lung function, and quality of life. Primary clinical endpoints are shown in Table 1:View this table:CONCLUSIONS: Cyclical administration of ICS with 3-day breaks is not less efficient than their daily use and may be offered to some patients with mild persistent asthma as an intermediate step to the withdrawal of controller medication if their disease is well controlled by regular treatment with ICS. ER -