Asthma is a common chronic inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction and bronchospasm. It is thought to be caused by a combination of genetic and environmental factors with treatment usually involving daily treatment with inhaled steroids such as Pulmicort. Recent research now contests that the current recommended daily dosing of inhaled steroids for children under the age of five may be just as effective as less frequent treatments with a higher dose of inhaled steroids, leading to an overall reduced exposure to the drug.
The research compared outcomes among 278 high-risk preschoolers treated with either the occasional inhaled steroid regimen of the recommended daily regimen. Study researcher, Zeiger, found the treatments to be equally effective for reducing the frequency of wheezing episodes that required the use of oral steroids over the course of a year. “We showed that daily treatment was not superior to intermittent treatment, ‘says Zeiger of the Childhood Asthma Research and Education (CARE) Network. ‘And even though the dose used in the intermittent regimen was four times higher than that used for daily treatment, the cumulative dosage was threefold lower among children in the study’.
The year long study found that on average every 3.5 months the occasional group was being treated and their cumulative dose of the drug was 100milligrams less over the course of the year compared to the children treated daily with 0.5 milligrams.
With these new findings, further research in to the effects of inhaled steroids and the risk for impaired growth is needed. ‘The implication is that if you are giving less steroid overall there will be less impact on growth, but that remains to be seen,’ pulmonary specialist Len Horovitz, MD, of Lenox Hill Hospital in New York City. “It could be that there is more absorption with the higher-dose intermittent regimen, even though the cumulative dose is not as great.” Advances in respiratory health continue to evolve and new questions raised. The occasional dosing schedule may be a more attractive option to parents given the convenience and possible financial and growth implications for the child.
Asthma Health Centre. Daily Steroids May Not Be Needed for Wheezing. Updated Nov 24. Retrieved from http://www.webmd.com/asthma/news/20111122/daily-steriods-may-not-be-needed-for-wheezing