Efficacy and safety of inhaled corticosteroids in combination with a long-acting beta2-agonist in asthmatic children under age 5.
The incidence of asthma in children under age 5 is higher than in any other segment of the population. Current NAEPP guidelines recommend treatment of some asthmatics in this age group with the combination of an inhaled corticosteroid and a long-acting beta2-agonist even though this practice has never been studied with children younger than 4. This retrospective study analyzes the efficacy and safety of a combination of fluticasone propionate (FP) and salmeterol (SA) in children under 5. Fifty patients who started using FP/SA before the age of 60 months were included in the analysis. To determine efficacy, we tracked the change in emergency room visits, hospitalizations, and the frequency of wheezing as a result of treatment. Emergency room visits were reduced from 78 to 5 (p<0.001), hospitalizations were reduced from 43 to 2 (p<0.001) and frequency of wheezing, daily, weekly, or monthly, was also reduced significantly (p<0.003). In terms of safety, there was only a 3.4% reduction in height percentile (p=0.37). Combination therapy is highly efficacious and safe for asthmatics under the age of 5. A well-designed prospective study is necessary to further evaluate the benefits and risks of this treatment method.
Sekhsaria
Sudhir
S
Union Memorial Hospital, Baltimore, Maryland 21218, USA. asthma4@yahoo.com
Alam
Mikhayl
M
Sait
Tahir
T
Starr
Barnaby
B
Parekh
Monica
M
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000420:Albuterol / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D000730:Androstadienes / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D000068299:Salmeterol Xinafoate
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000730:Androstadienes; D001993:Bronchodilator Agents; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D000420:Albuterol