title: Intramuscular triamcinolone for difficult asthma.
abstract: We treated a selected group of children attending a difficult asthma clinic with intramuscular triamcinolone acetonide. This study retrospectively reviews markers of asthma severity in those who received one or more monthly doses for three periods: 1) 3 months preceding the first injection (pretreatment), 2) from the first injection to 1 month after the last injection (treatment period), and 3) 3 months after the treatment period (follow-up period). Severity markers during the treatment and follow-up periods were compared with the pretreatment period by paired t-test. Five children (5-13 years old) received a single dose, and 8 children (12-15 years old) received multiple doses. Multiple doses of triamcinolone (n = 3-5) were associated with a fall in the number of asthma exacerbations (P < 0.01) and hospital admissions (P < 0.01) in both the treatment and follow-up periods. A single dose reduced exacerbations (P < 0.05, treatment vs. pretreatment) but not hospital admissions. We conclude that intramuscular triamcinolone is a useful short-term therapy in difficult asthma. Whether its efficacy is due to improved compliance, or an improved anti-inflammatory profile compared with oral steroids, remains unclear.
authors.affiliation: Leicester Children's Asthma Centre, Department of Child Health, University of Leicester, Leicester, UK.
authors.forename: Jayachandran R
authors.initials: JR
authors.lastname: Panickar
authors.forename: Priti
authors.initials: P
authors.lastname: Kenia
authors.forename: Michael
authors.initials: M
authors.lastname: Silverman
authors.forename: Jonathan
authors.initials: J
authors.lastname: Grigg
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D015415:Biomarkers / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D010343:Patient Admission; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D005938:Glucocorticoids; D011239:Prednisolone; D014222:Triamcinolone Acetonide