Publication

Inhaled corticosteroids in childhood asthma: the story continues

van Aalderen, W. M. C. & Sprikkelman, A. B., Jun-2011, In : European Journal of Pediatrics. 170, 6, p. 709-718 10 p.

Research output: Contribution to journalReview articleAcademicpeer-review

Inhaled corticosteroids (ICS) are the most effective anti-inflammatory drugs for the treatment of persistent asthma in children. Treatment with ICS decreases asthma mortality and morbidity, reduces symptoms, improves lung function, reduces bronchial hyperresponsiveness and reduces the number of exacerbations. The efficacy of ICS in preschool wheezing is controversial. A recent task force from the European Respiratory Society on preschool wheeze defined two different phenotypes: episodic viral wheeze, wheeze that occurs only during respiratory viral infections, and multiple-trigger wheeze, where wheeze also occurs in between viral episodes. Treatment with ICS appears to be more efficacious in the latter phenotype. Small particle ICS may offer a potential benefit in preschool children because of the favourable spray characteristics. However, the efficacy of small particle ICS in preschool children has not yet been evaluated in prospective clinical trials. The use of ICS in school children with asthma is safe with regard to systemic side effects on the hypothalamic-pituitary-adrenal axis, growth and bone metabolism, when used in low to medium doses. Although safety data in wheezing preschoolers is limited, the data are reassuring. Also for this age group, adverse events tend to be minimal when the ICS is used in appropriate doses.

Original languageEnglish
Pages (from-to)709-718
Number of pages10
JournalEuropean Journal of Pediatrics
Volume170
Issue number6
Publication statusPublished - Jun-2011
Externally publishedYes

    Keywords

  • Inhaled corticosteroids, Asthma, Children, Preschool, Safety, Wheeze, DIPROPIONATE EXTRAFINE AEROSOL, HIGH-DOSE FLUTICASONE, PRESCHOOL-CHILDREN, BECLOMETHASONE DIPROPIONATE, PERSISTENT ASTHMA, YOUNG-CHILDREN, PREPUBERTAL CHILDREN, LUNG-FUNCTION, EFFICACY, SAFETY

ID: 71334953