Wheezy Preschoolers
Daily use of inhaled corticosteroids for preschool children with a history of intermittent wheezing does not prevent progression to asthma.
Frequent episodes of wheezing are common in infants and toddlers. These episodes are successfully treated with asthma medications, such as inhaled bronchodilators (albuterol or salbutamol), inhaled corticosteroids (an ICS such as budesonide or fluticasone), and if severe, oral corticosteroids (such as prednisolone or prednisone). These treatments are usually necessary only for 1 - 3 weeks. About half of these children do not have asthma by the time they reach school age (5 or 6 years old), so pediatricians often do not give them the diagnostic label of asthma.
Some pediatricians wondered if giving these children an ICS every day for a year more would reduce their risk of developing asthma. A theory which is widely believed states that permanent damage occurs (airway remodeling) when asthma is not treated early and religiously. So the NIH funded a large study done at 7 university medical centers in the United States to examine this theory.
285 children ages 2 or 3 were enrolled in the study. All had at least 4 episodes of wheezing during the previous year, and additional risk factors such as eczema (an allergic rash) or a parent with asthma. The children were randomly assigned to take a low daily dose of Flovent (fluticasone) or a placebo inhaler for two years. At the end of the two years of treatment they were followed for an additional year.
The group of toddlers taking Flovent every day didn't grow as quickly as those taking a placebo. On the average, they were about one-half inch shorter, a known ICS side effect. Those taking the drug had fewer wheezing episodes during the first two years, but the same number during the final year when they were no longer taking the fluticasone every day. It's unlikely that pediatricians will be able to convince many parents to give their young child an ICS twice per day, every day, to somewhat reduce the number of wheezing episodes each year but not alter the risk of chronic asthma.
A European study, published in the same issue of the New England Journal of Medicine, found that ICS therapy for infants up to age two also did not prevent progression to asthma. These studies are a blow to companies like GSK and Astra-Zeneca (who were hoping to expand their ICS sales) and to parents eager to reduce the 50% risk that their infant or toddler with wheezing episodes will develop asthma. The majority of these wheezing episodes are caused by respiratory viruses. Only a minority are caused by exposure to allergens, smoke, or air pollution.
Related Topics: New Clue to Development of Asthma, Early Asthma, Later Lung Damage
Technorati Tags: asthma, childhood asthma, inhaled corticosteroids
Frequent episodes of wheezing are common in infants and toddlers. These episodes are successfully treated with asthma medications, such as inhaled bronchodilators (albuterol or salbutamol), inhaled corticosteroids (an ICS such as budesonide or fluticasone), and if severe, oral corticosteroids (such as prednisolone or prednisone). These treatments are usually necessary only for 1 - 3 weeks. About half of these children do not have asthma by the time they reach school age (5 or 6 years old), so pediatricians often do not give them the diagnostic label of asthma.
Some pediatricians wondered if giving these children an ICS every day for a year more would reduce their risk of developing asthma. A theory which is widely believed states that permanent damage occurs (airway remodeling) when asthma is not treated early and religiously. So the NIH funded a large study done at 7 university medical centers in the United States to examine this theory.
285 children ages 2 or 3 were enrolled in the study. All had at least 4 episodes of wheezing during the previous year, and additional risk factors such as eczema (an allergic rash) or a parent with asthma. The children were randomly assigned to take a low daily dose of Flovent (fluticasone) or a placebo inhaler for two years. At the end of the two years of treatment they were followed for an additional year.
The group of toddlers taking Flovent every day didn't grow as quickly as those taking a placebo. On the average, they were about one-half inch shorter, a known ICS side effect. Those taking the drug had fewer wheezing episodes during the first two years, but the same number during the final year when they were no longer taking the fluticasone every day. It's unlikely that pediatricians will be able to convince many parents to give their young child an ICS twice per day, every day, to somewhat reduce the number of wheezing episodes each year but not alter the risk of chronic asthma.
A European study, published in the same issue of the New England Journal of Medicine, found that ICS therapy for infants up to age two also did not prevent progression to asthma. These studies are a blow to companies like GSK and Astra-Zeneca (who were hoping to expand their ICS sales) and to parents eager to reduce the 50% risk that their infant or toddler with wheezing episodes will develop asthma. The majority of these wheezing episodes are caused by respiratory viruses. Only a minority are caused by exposure to allergens, smoke, or air pollution.
Related Topics: New Clue to Development of Asthma, Early Asthma, Later Lung Damage
Technorati Tags: asthma, childhood asthma, inhaled corticosteroids
2 Comments:
I am a doctorial nursing student looking for any information available about the experience of asthma in the preschool population from the viewpoint of the preschooler, i.e. what is it like to be a preshooler with asthma.
yes i would like to know if my medcine would prevent me from getting to sleep cause i have a hard time sleeping was just wondering if insomia is caused by the meds u take ty u can get back to me at onyx865@yahoo.com i appreciate it very much
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