title: Cough after inhalation of corticosteroids delivered from spacer devices in children with asthma.
abstract: Children using a spacer device rather than another device for delivering inhaled corticosteroids (ICS) has been identified as a risk factor for cough immediately after inhalation. The aim of this study was to point out the different factors influencing the occurrence of such lateral side-effects. We studied this local side-effect in 402 asthmatic children (55.6 +/- 34.9 months; 65.6% boys) treated for at least 1 month with beclomethasone dipropionate (n = 331), budesonide (n = 47) or fluticasone propionate (n = 24) delivered from pressurized metered-dose inhalers and small (75.1%) or large volume (24.8%) spacer devices mainly used with face mask (90.7%). A total of 219 patients (54.5%), treated with either high doses of ICS or ICS and long-acting beta2-agonist, were considered as having severe asthma. Cough was reported after each inhalation of corticosteroids in 216 patients (53.7%). Among them, about 30% also complained of cough with beta2-agonists. Despite different propellants and dispersants, all corticosteroids induced cough similarly. Cough was not linked with asthma severity, but was significantly related to therapy duration and use of long-acting beta2-agonist. Type and volume of the spacer device, use of a face mask or mouthpiece were not influencing factors. Cough after inhalation of corticosteroids delivered from spacer devices is a frequent local side-effect in children with asthma. This side effect can greatly alter compliance. A practitioner must be sought at each visit.
authors.affiliation: Department of Pediatrics, Timone Children's University Hospital, Marseille, France. jean-christophe.dubus@ap-hm.fr
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Dubus
authors.forename: Laurent
authors.initials: L
authors.lastname: Mély
authors.forename: Laetitia
authors.initials: L
authors.lastname: Huiart
authors.forename: Christophe
authors.initials: C
authors.lastname: Marguet
authors.forename: Pascal
authors.initials: P
authors.lastname: Le Roux
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage* / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003371:Cough / Q000139:chemically induced*; D016503:Drug Delivery Systems / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D036501:Metered Dose Inhalers / Q000009:adverse effects*
chemical_list: D001507:Beclomethasone