Temporarily increasing the amount of inhaled steroids that young children take when their asthma symptoms worsen does not prevent severe flare-ups, according to a new study from the National Institutes of Health.
The findings buck traditional medical practice involving kids with mild-to-moderate asthma. Asthma flare-ups are common among children with asthma and most doctors recommend boosting a patient’s dose of inhaled steroids from low to high at the first sign of coughing and wheezing.
“These findings suggest that a short-term increase to high-dose inhaled steroids should not be routinely included in asthma treatment plans for children with mild-moderate asthma who are regularly using low-dose inhaled corticosteroids,” study leader Dr. Daniel Jackson said in prepared remarks. “Low-dose inhaled steroids remain the cornerstone of daily treatment in affected children.”
The researchers evaluated 254 kids, ages 5 to 11, over the course of one year. All of the participants were given two puffs from an inhaler twice per day. At the first signs of a flare-up, researchers continued giving low-dose inhaled steroids to half of the kids and switched to high-dose inhaled steroids for the other half of the kids, two times per day for seven days during each flare-up episode.
The kids in the high-dose group experienced similar asthma symptoms compared to the kids in the low-dose group, according to the researchers, and had a similar length of time until the first severe flare-up.
The researchers also noted that children in the short-term high-dose group grew at a lesser rate than those in the low-dose group. The growth difference was small, but the team said the finding is consistent with previous studies.
“This study allows caregivers to make informed decisions about how to treat their young patients with asthma,” James Kiley, director of the National Heart, Lung and Blood Institute’s lung disease division, said. “Trials like this can be used in the development of treatment guidelines for children with asthma.”