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Inhaled Corticosteroids Most Effective for Persistent Asthma In Children

Inhaled corticosteroids (ICS) and leukotriene receptor antagonists (LTRA) have both been proven to help control mild to moderate persistent asthma in school-age children, but, a new study shows that ICS may be the more effective treatment. The study, Response Profiles to Fluticasone and Montelukast in Mild-to-Moderate Persistent Childhood Asthma, is featured in the January 2006 issue of the Journal of Allergy & Clinical Immunology (JACI). The JACI is the peer-reviewed, scientific journal of the American Academy of Allergy, Asthma and Immunology (AAAAI).

The study, conducted over a 16-week period, was a multi-center, double-masked, 2-sequence crossover trial by the National Heart, Lung and Blood Institute (NHLBI) Childhood Asthma Research and Education (CARE) Network. Researchers, led by Robert S. Zeiger, MD, PhD, from the University of California San Diego Department of Pediatrics, administered either an ICS, a fluticasone propionate, twice daily or an LTRA, a montelukast, each night to over 100 children with mild to moderate persistent asthma. The children ranged from 6 to 17 years old.

Research Findings
As expected, researchers found both fluticasone and montelukast led to significant improvements in many measures of asthma control. But, similar to earlier research, they found strong evidence of greater mean improvements after 8 weeks of therapy with an ICS compared with a LTRA across many other outcomes.

The children who took ICS as a treatment experienced more asthma control days in which they had no daytime or nighttime asthma symptoms. These children also experienced better pulmonary responses and inflammatory biomarkers. As a comparison, 29.3 % of participants had at least one more asthma control day per week during treatment with fluticasone than during treatment with montelukast (12.2 %).

The results of this study indicate that inhaled corticosteroids may be the most effective treatment for persistent asthma in children. It is best to discuss all treatment options with the child’s physician in order to effectively choose the correct treatment.


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