Sunday, March 20, 2005

Corticosteroid Treatment Effective for Children's Asthma

New studies are confirming the benefit of treating young asthmatic children with inhaled corticosteroids.

"It's not new information, but it backs up what we know," said allergy expert Dr. Clifford Bassett, a clinical assistant professor of medicine at the State University of New York. "It's viable as a long-term treatment." A pharmacological corticosteroid is a hormone similar to those produced by the adrenal cortex, such as cortisol and aldosterone. These hormones have been shown to be effective in combatting asthma.

The studies were presented Saturday at the annual meeting of the American Academy of Allergy, Asthma and Immunology in San Antonio.

According to background information, the proportion of American children with asthma has grown from 3.6 percent to 6.2 percent. Children under the age of 5 have the highest rate of hospitalization from the disease.

"Asthma in young children results in significant morbidity," said Dr. Kevin Murphy, lead author of one of the studies and a clinical professor of pediatrics at the University of Nebraska Medical Center in Omaha. "It's the No. 1 chronic disease in children."

Murphy's study was a retrospective analysis of 11,407 children under 5 years old who had been diagnosed with asthma and were taking medication for their condition.

Those who were given inhaled corticosteroids first (before any other medication) had fewer emergency room visits than those who were prescribed the therapy first or second: 25 percent of the kids who got inhaled corticosteroids first had an emergency room visit or a hospital stay at least once during a year vs. 29 percent of those who had the drug prescribed second and 41 percent of those who had it prescribed third.

"The earlier you get it, the better," Murphy said. "This should encourage people to think about early intervention."

A second study looked at 1,974 children 5 to 10 years old who were randomized to receive either budesonide, an inhaled corticosteroid, once a day or a placebo. All the participants also took their regular asthma medications.

Use of budesonide earlier reduced the risk of an exacerbation by 40 percent. These children also had less of a need to use their other mediation (12 percent versus 23 percent).

"When we added budesonide, we saw a significant decrease in asthma," said Dr. Albert Sheffer, chairman of the study safety committee and a clinical professor of medicine at Harvard Medical School in Boston.

Children taking budesonide, however, did have slowed growth, Sheffer added, but they caught up after five years.

The frequency of other side effects was similar in both groups

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