[Comparative efficacy of oral deflazacort versus oral prednisolone in children with moderate acute asthma].
OBJECTIVE
To assess the efficacy and tolerability of oral deflazacort versus oral prednisolone in acute moderate asthma in children.


METHODS
We performed a prospective, randomized, parallel group trial of children aged 6 to 14 years old with a diagnosis of asthma who presented to the pediatric emergency department for moderate asthma exacerbation. All patients were administered short-acting beta2-adrenergic agonists. The intervention groups received either oral deflazacort (1.5 mg/kg) or prednisolone (1 mg/kg) for 7 days. The primary outcome measure was forced expiratory volume in 1 second (FEV1) and secondary outcome measures were pulmonary symptom score index, peak expiratory flow rate (PEFR), hospitalization rate and the use of rescue beta2-agonists. Patients were evaluated at the start of treatment (visit 1), on day 2 (visit 2) and on day 7 (visit 3).


RESULTS
Of the 54 children enrolled, two were hospitalized on visit 2 (one from each group). Baseline clinical data were similar in both groups: FEV1: 53 and 51 %; bronchodilator test: 119 and 121 %; PEFR: 169 and 165 L/min; symptom score: 6 and 6.5 for the deflazacort and prednisolone groups, respectively. On visit 2, all measures improved: FEV1: 122.2 and 126.5 % (p < 0.05); PEFR: 164 and 149 L/min (p < 0.05); symptom score: -4.4 and -3.8 (p < 0.05), without significant differences between groups. On visit 3 all variables continued to show improvement: FEV1: 133.2 and 132.5 % (p < 0.05); PEFR: 1115.7 and 187.6 L/min (p < 0.05); symptom score: -5.4 and -5.9 (p < 0.05), without significant differences between groups. No adverse effects were reported.


CONCLUSIONS
Deflazacort and prednisolone show similar efficacy in improving pulmonary function and in producing clinical improvement in the management of acute moderate asthma in children.
Unidad de Neumología y Fibrosis Quística, Hospital Universitari Vall d'Hebron, Barcelona, Spain. sgartner@vhebron.net
S
S
Gartner
N
N
Cobos
E G
EG
Pérez-Yarza
A
A
Moreno
C
C
De Frutos
S
S
Liñan
J
J
Mintegui
D000284:Administration, Oral; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010366:Peak Expiratory Flow Rate; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D011282:Pregnenediones / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D016896:Treatment Outcome
D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D011282:Pregnenediones; D011239:Prednisolone; C021988:deflazacort