Alternative Way to Treat Childhood Asthma?
Study Suggests Role for Inhaled Steroids as Rescue Medication
Study Details continued...
Children and adolescents in the daily group had fewer asthma exacerbations (28%) than those in the placebo group (49%).
Treatment failure occurred 23% in the placebo group, compared with 6% in the combined, 3% in the daily group, and 8.5% in the rescue group.
The researchers also looked at growth restriction and found that growth was on average 1.1 centimeter less over the course of the 44-week study period in the combined and daily groups than in the placebo group. There was no difference in growth in the rescue group compared to the placebo group.
More study is needed to confirm the new study findings, Martinez says. “Our results were very suggestive, but statistically borderline and with small numbers,” he says. “A larger definitive study is needed.”
Always Discuss Medication Changes With a Doctor First
“This is some important and landmark work,” says Harold J. Farber, MD, an associate professor of the pediatric pulmonary section at Baylor College of Medicine and Texas Children Hospital in Houston and author of Control Your Child's Asthma.
“Starting the steroid beclomethasone along with albuterol at onset of symptoms gave almost as good of a benefit in prevention as daily inhaled steroid therapy,” he says.
But “for it to work, you have to start it early at first sign of an attack,” he says. “If we wait for severe problems, it’s too little too late.”
This advice is only good for “folks with mild asthma, not folks with moderate to severe asthma,” he says. “If you have moderate to severe asthma, the use of inhaled corticosteroid every day is better than as-needed use.”
“Always talk with your doctor before making any changes to medication,” Farber says.
“When used as a rescue modality, inhaled steroids (beclomethasone) do a reasonable job at controlling symptoms without the side effects of reduced growth,” says William Checkley, MD, assistant professor in the Division of Pulmonary and Critical Care of the Johns Hopkins School of Medicine in Baltimore. “This step-down approach reduces the need to do puffs twice a day.”
But “there have to be more studies to support these findings,” he says. Checkley wrote an editorial accompanying the study.