title: Prednisolone reduces recurrent wheezing after first rhinovirus wheeze: a 7-year follow-up.
abstract: BACKGROUND
  To better understand the role of human rhinovirus-associated wheeze as a risk factor for childhood recurrent wheezing, a cohort of young children experiencing their first wheezing episode was followed until school age.
  
  
  METHODS
  All 111 hospitalized wheezing children (median age, 12 months) were initially participated in a randomized, double-blind, placebo-controlled, parallel trial on the efficacy of oral prednisolone. In this 7-yr follow-up, risk factors for recurrent wheezing were analysed, and then, the efficacy of prednisolone was evaluated overall and in pre-specified subgroups post-hoc. The main outcome was time to recurrent wheezing.
  
  
  RESULTS
  The strongest independent risk factor for recurrent wheezing was rhinovirus detection (hazard ratio 3.54; 95% confidence interval 1.51-8.30) followed by sensitization (3.47; 1.55-8.30, respectively) age <1 yr (2.45; 1.29-4.65) and eczema (2.33; 1.11-4.90). Overall, prednisolone did not prevent recurrent wheezing. In subgroup analysis, prednisolone was associated with less recurrent wheezing in children affected by rhinovirus (0.32; 0.12-0.90, adjusted to sensitization, young age, viral aetiology and parental asthma) and/or with eczema (0.27; 0.08-0.87, adjusted respectively).
  
  
  CONCLUSIONS
  Our data strengthen the role of rhinovirus-associated wheeze as an important risk factor for recurrent wheezing and asthma in young first-time wheezing children. Prospective randomized trials on the efficacy of corticosteroids in rhinovirus-associated early wheezing are warranted. (ClinicalTrials.gov number, NCT 00494624).
authors: Department of Paediatrics, Turku University Hospital, Turku, Finland. mimapo@utu.fi
authors: Minna
authors: M
authors: Lukkarinen
authors: Heikki
authors: H
authors: Lukkarinen
authors: Pasi
authors: P
authors: Lehtinen
authors: Tytti
authors: T
authors: Vuorinen
authors: Olli
authors: O
authors: Ruuskanen
authors: Tuomas
authors: T
authors: Jartti
mesh_terms: D000284:Administration, Oral; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D008297:Male; D010850:Picornaviridae Infections / Q000150:complications*; D011239:Prednisolone / Q000008:administration & dosage*; D012008:Recurrence; D012135:Respiratory Sounds / Q000187:drug effects* / Q000209:etiology*; D012229:Rhinovirus / Q000187:drug effects*; D012306:Risk; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone
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