Easing Kids' Breathing Before Asthma
Study: Inhaled Steroids Cut Asthma-Like Symptoms During Treatment
May 10, 2006 -- For young kids at high risk of asthma, inhaled corticosteroids may ease
asthma-like symptoms. But those benefits don't last after steroids are stopped,
a new study shows.
The study appears in The New England Journal of Medicine. It
included 285 kids who were about 3 years old when the three-year study
All of the kids were at high risk for asthma. They had had at least four wheezing episodes, with at least one of those
episodes diagnosed by a doctor. They also had at least one or two other asthma
risk factors, such as doctor-diagnosed atopic dermatitis (eczema) or parental history of asthma.
The kids may have also had allergies, but not any other serious health
problems. More than half of the kids were white (53%), while 12% were black,
20% were Hispanic, and about 15% were from other racial or ethnic groups.
Two Years of Treatment
The researchers included Theresa Guilbert, MD, of the Arizona Respiratory
Center at the University of Arizona in Tucson. They randomly assigned the kids
to two groups.
For two years, one group of kids used two daily doses of the inhaled
corticosteroid Flovent. The other group got a placebo treatment that lacked any
Afterward, the researchers stopped the daily inhaled Flovent and followed
the kids for an extra year of observation. Throughout the study, the
researchers interviewed the kids' parents about the children's asthma-like
symptoms (coughing and wheezing). The interviews covered the kids' symptoms
during the previous two weeks.
Children in both groups were treated as needed, if problems developed.
During the two-year treatment period, children that used Flovent had a
greater proportion of days without asthma-like symptoms than kids in the placebo
Compared with the placebo group, the Flovent group also had a lower rate of
worsening asthma symptoms that required further steroid treatment (such as
steroid pills), the study also shows.
But those benefits didn't last into the observation year when none of the
kids used daily Flovent.
"Clinical improvement was observed while the children were treated with
inhaled corticosteroid but disappeared after treatment had been
discontinued," write the researchers.
"Our data suggest that inhaled corticosteroids have little therapeutic
effect on the processes that determine the progression of the disease from its
initial, intermittent stages to a more chronic form, as described in the
epidemiology literature," Guilbert and colleagues add.
During the two-year treatment period, all of the kids grew taller. But there
was a slight difference in height gain between the two groups.
The average height increase after 24 months of treatment was about
four-tenths of an inch (1.1 centimeters) less for kids in the Flovent group,
compared with the placebo group.